- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,897.79 / $16,218.10
| Facility | | $1,023.29 | $4,897.79 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $35,481.34 / $52,480.75
| Facility | | $4,570.88 | $35,481.34 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $691.83 / $794.33
| Facility | | $630.96 | $691.83 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $16,218.10
| Facility | | $13,489.63 | $13,489.63 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,748.98 / $17,378.01
| Facility | | $5,011.87 | $11,748.98 | $17,378.01 |