- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,100.08 / $23,483.17
| Facility | | $5,463.36 | $11,100.08 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,605.99 / $31,992.18 / $60,057.49
| Facility | | $23,605.99 | $31,992.18 | $60,057.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.54 / $942.99 / $16,787.84
| Facility | | $552.54 | $942.99 | $16,787.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $996.38 / $1,259.08 / $1,767.62
| Facility | | $996.38 | $1,259.08 | $1,767.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |