- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $9,120.11 / $16,595.87
| Facility | | $2,344.23 | $9,120.11 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $34,673.69 / $64,565.42
| Facility | | $15,135.61 | $34,673.69 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,230.27 / $1,995.26
| Facility | | $870.96 | $1,230.27 | $1,995.26 |
- 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 |