- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $10,471.29 / $18,197.01
| Facility | | $2,041.74 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,912.51 / $16,595.87
| Facility | | $3,715.35 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,041.74 / $2,041.74
| Facility | | $2,041.74 | $2,041.74 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,047.13 / $1,905.46
| Facility | | $794.33 | $1,047.13 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,442.29
| Facility | | $5,128.61 | $13,182.57 | $23,442.29 |