- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,917.20 / $9,640.26 / $27,698.67
| Facility | | $4,917.20 | $9,640.26 | $27,698.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,392.42 / $45,235.44 / $87,499.94
| Facility | | $34,392.42 | $45,235.44 | $87,499.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.59 / $680.41 / $53,412.59
| Facility | | $456.59 | $680.41 | $53,412.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.87 / $1,073.46 / $52,510.04
| Facility | | $711.87 | $1,073.46 | $52,510.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,221.00 / $14,989.00 / $44,635.00
| Facility | | $11,221.00 | $14,989.00 | $44,635.00 |