- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $4,897.79 / $7,244.36
| Facility | | $758.58 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $23,442.29 / $31,622.78
| Facility | | $2,884.03 | $23,442.29 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $524.81 / $588.84
| Facility | | $501.19 | $524.81 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $3,801.89
| Facility | | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,220.18 / $17,378.01
| Facility | | $4,897.79 | $11,220.18 | $17,378.01 |