- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.27 / $5,000.27 / $7,838.38
| Facility | | $5,000.27 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,084.79 / $11,293.01 / $17,865.91
| Facility | | $9,084.79 | $11,293.01 | $17,865.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.89 / $257.89 / $1,996.40
| Facility | | $257.89 | $257.89 | $1,996.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.85 / $318.43 / $554.63
| Facility | | $212.85 | $318.43 | $554.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,092.00 / $2,092.00 / $7,773.00
| Facility | | $2,092.00 | $2,092.00 | $7,773.00 |