- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $3,467.37 / $25,118.86
| Facility | | $1,174.90 | $3,467.37 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $20,892.96 / $28,840.32
| Facility | | $11,748.98 | $20,892.96 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $15,848.93 / $15,848.93
| Facility | | $39.81 | $15,848.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $7,079.46 / $16,218.10
| Facility | | $1,202.26 | $7,079.46 | $16,218.10 |