- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $9,120.11 / $19,952.62
| Facility | | $1,047.13 | $9,120.11 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $33,884.42 / $64,565.42
| Facility | | $9,332.54 | $33,884.42 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,202.26 / $2,089.30
| Facility | | $812.83 | $1,202.26 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $24,547.09 / $43,651.58
| Facility | | $5,754.40 | $24,547.09 | $43,651.58 |