- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,467.37 / $4,897.79
| Facility | | $1,380.38 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $25,118.86 / $33,113.11
| Facility | | $10,471.29 | $25,118.86 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $891.25 / $1,023.29
| Facility | | $851.14 | $891.25 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,445.44 / $1,905.46
| Facility | | $912.01 | $1,445.44 | $1,905.46 |
- 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 |