- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $4,897.79 / $12,022.64
| Facility | | $1,148.15 | $4,897.79 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $28,183.83 / $41,686.94
| Facility | | $5,128.61 | $28,183.83 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,023.29 / $1,174.90
| Facility | | $933.25 | $1,023.29 | $1,174.90 |
- 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
- $5,128.61 / $11,220.18 / $17,378.01
| Facility | | $5,128.61 | $11,220.18 | $17,378.01 |