- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $3,467.37 / $4,897.79
| Facility | | $1,202.26 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $25,703.96 / $32,359.37
| Facility | | $9,772.37 | $25,703.96 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $776.25 / $870.96
| Facility | | $741.31 | $776.25 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,258.93 / $1,659.59
| Facility | | $794.33 | $1,258.93 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,754.40 / $12,022.64
| Facility | | $1,412.54 | $5,754.40 | $12,022.64 |