- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $4,897.79 / $7,244.36
| Facility | | $812.83 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $28,183.83 / $39,810.72
| Facility | | $2,884.03 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $660.69 / $741.31
| Facility | | $588.84 | $660.69 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $7,943.28
| Facility | | $6,760.83 | $6,760.83 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,220.18 / $17,378.01
| Facility | | $5,011.87 | $11,220.18 | $17,378.01 |