- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $4,897.79 / $14,125.38
| Facility | | $1,202.26 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $30,902.95 / $50,118.72
| Facility | | $7,413.10 | $30,902.95 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $812.83 / $912.01
| Facility | | $741.31 | $812.83 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,288.25 / $1,819.70
| Facility | | $891.25 | $1,288.25 | $1,819.70 |
- 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 |