- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,495.41 / $28,183.83
| Facility | | $1,621.81 | $5,495.41 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $8,128.31 / $18,620.87
| Facility | | $4,073.80 | $8,128.31 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $5,370.32 / $5,495.41
| Facility | | $5,370.32 | $5,370.32 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,659.59 / $3,801.89
| Facility | | $977.24 | $1,659.59 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,218.10 / $22,908.68
| Facility | | $12,882.50 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $11,748.98 / $29,512.09
| Facility | | $2,570.40 | $11,748.98 | $29,512.09 |