- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,398.83 / $6,918.31
| Facility | | $660.69 | $2,398.83 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,018.94 / $42,657.95 / $63,095.73
| Facility | | $38,018.94 | $42,657.95 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $323.59
| Facility | | $204.17 | $204.17 | $323.59 |