- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $21,899.37
| Facility | | $5,463.36 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,856.25 / $22,987.11 / $40,340.87
| Facility | | $15,856.25 | $22,987.11 | $40,340.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.60 / $1,248.93 / $2,111.35
| Facility | | $724.60 | $1,248.93 | $2,111.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,447.54 / $1,808.44 / $5,269.25
| Facility | | $1,447.54 | $1,808.44 | $5,269.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |