- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $4,897.79 / $27,542.29
| Facility | | $1,258.93 | $4,897.79 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $7,762.47 / $28,840.32
| Facility | | $2,344.23 | $7,762.47 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $17,378.01 / $54,954.09
| Facility | | $9,120.11 | $17,378.01 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $6,918.31 / $77,624.71
| Facility | | $489.78 | $6,918.31 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,943.28 / $30,902.95
| Facility | | $4,570.88 | $7,943.28 | $30,902.95 |