- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $4,897.79 / $11,220.18
| Facility | | $912.01 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,454.40 / $19,498.45
| Facility | | $6,456.54 | $14,454.40 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $676.08 / $758.58
| Facility | | $602.56 | $676.08 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,071.52 / $1,380.38
| Facility | | $691.83 | $1,071.52 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,370.32 / $10,715.19
| Facility | | $2,398.83 | $5,370.32 | $10,715.19 |