- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $4,897.79 / $7,244.36
| Facility | | $891.25 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $28,183.83 / $39,810.72
| Facility | | $2,884.03 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $602.56 / $676.08
| Facility | | $537.03 | $602.56 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $5,623.41 / $5,623.41
| Facility | | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,025.60 / $12,022.64
| Facility | | $3,388.44 | $6,025.60 | $12,022.64 |