- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,467.37 / $4,897.79
| Facility | | $2,041.74 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $29,512.09 / $39,810.72
| Facility | | $12,589.25 | $29,512.09 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $2,238.72 / $2,511.89
| Facility | | $1,995.26 | $2,238.72 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,311.31 / $4,677.35
| Facility | | $2,290.87 | $3,311.31 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,623.41 / $12,022.64
| Facility | | $1,412.54 | $5,623.41 | $12,022.64 |