- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,897.79 / $17,378.01
| Facility | | $1,023.29 | $4,897.79 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $18,197.01 / $26,302.68
| Facility | | $5,623.41 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $707.95 / $794.33
| Facility | | $676.08 | $707.95 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,148.15 / $1,479.11
| Facility | | $707.95 | $1,148.15 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,549.93 / $16,218.10
| Facility | | $4,466.84 | $9,549.93 | $16,218.10 |