- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,897.79 / $17,378.01
| Facility | | $1,288.25 | $4,897.79 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $38,904.51 / $57,543.99
| Facility | | $12,589.25 | $38,904.51 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,174.90 / $1,318.26
| Facility | | $1,122.02 | $1,174.90 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,659.59 / $2,398.83
| Facility | | $1,174.90 | $1,659.59 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $13,803.84 / $20,417.38
| Facility | | $6,456.54 | $13,803.84 | $20,417.38 |