- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $8,317.64 / $28,183.83
| Facility | | $1,096.48 | $8,317.64 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $18,620.87 / $26,302.68
| Facility | | $5,623.41 | $18,620.87 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $831.76 / $954.99
| Facility | | $794.33 | $831.76 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $2,951.21
| Facility | | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,762.47 / $10,964.78
| Facility | | $4,073.80 | $7,762.47 | $10,964.78 |