- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $4,897.79 / $14,125.38
| Facility | | $1,148.15 | $4,897.79 | $14,125.38 |
- 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
- $691.83 / $776.25 / $870.96
| Facility | | $691.83 | $776.25 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,230.27 / $1,737.80
| Facility | | $851.14 | $1,230.27 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,762.47 / $10,964.78
| Facility | | $4,073.80 | $7,762.47 | $10,964.78 |