- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $16,218.10 / $34,673.69
| Facility | | $1,380.38 | $16,218.10 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $36,307.81 / $52,480.75
| Facility | | $5,623.41 | $36,307.81 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,230.27 / $1,412.54
| Facility | | $1,202.26 | $1,230.27 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,819.70 / $2,570.40
| Facility | | $1,230.27 | $1,819.70 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $11,220.18 / $17,378.01
| Facility | | $5,128.61 | $11,220.18 | $17,378.01 |