- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $4,897.79 / $11,220.18
| Facility | | $794.33 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $39,810.72 / $81,283.05
| Facility | | $4,466.84 | $39,810.72 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $537.03 / $602.56
| Facility | | $512.86 | $537.03 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $851.14 / $1,288.25
| Facility | | $537.03 | $851.14 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $13,803.84 / $22,387.21
| Facility | | $6,456.54 | $13,803.84 | $22,387.21 |