- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $4,365.16 / $11,220.18
| Facility | | $933.25 | $4,365.16 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $30,199.52 / $39,810.72
| Facility | | $4,168.69 | $30,199.52 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $831.76 / $933.25
| Facility | | $741.31 | $831.76 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $4,677.35 / $5,623.41
| Facility | | $4,677.35 | $4,677.35 | $5,623.41 |
- 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 |