- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $3,801.89 / $5,623.41
| Facility | | $467.74 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $39,810.72 / $81,283.05
| Facility | | $2,630.27 | $39,810.72 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $316.23 / $354.81
| Facility | | $281.84 | $316.23 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $13,182.57 / $15,848.93
| Facility | | $13,182.57 | $13,182.57 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,803.84 / $20,417.38
| Facility | | $6,165.95 | $13,803.84 | $20,417.38 |