- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,100.08 / $23,483.17
| Facility | | $5,463.36 | $11,100.08 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,744.80 / $41,753.08 / $80,763.95
| Facility | | $31,744.80 | $41,753.08 | $80,763.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,358.79 / $1,884.88 / $13,909.00
| Facility | | $1,358.79 | $1,884.88 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,129.79 / $2,646.73 / $3,790.72
| Facility | | $2,129.79 | $2,646.73 | $3,790.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |