- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,943.28 / $13,489.63
| Facility | | $4,570.88 | $7,943.28 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $23,988.33 / $50,118.72
| Facility | | $8,912.51 | $23,988.33 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $26,302.68 / $26,915.35
| Facility | | $26,302.68 | $26,302.68 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $14,454.40 / $41,686.94
| Facility | | $8,912.51 | $14,454.40 | $41,686.94 |