- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $4,897.79 / $16,218.10
| Facility | | $1,174.90 | $4,897.79 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $28,183.83 / $39,810.72
| Facility | | $5,128.61 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $851.14
| Facility | | $676.08 | $741.31 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $6,165.95 / $7,413.10
| Facility | | $6,165.95 | $6,165.95 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,549.93 / $16,218.10
| Facility | | $4,466.84 | $9,549.93 | $16,218.10 |