- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $11,748.98 / $31,622.78
| Facility | | $1,047.13 | $11,748.98 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $70,794.58 / $134,896.29
| Facility | | $26,915.35 | $70,794.58 | $134,896.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $30,902.95
| Facility | | $23,988.33 | $23,988.33 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $562.34 / $912.01
| Facility | | $380.19 | $562.34 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $32,359.37 / $83,176.38
| Facility | | $1,819.70 | $32,359.37 | $83,176.38 |