- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $9,120.11 / $17,378.01
| Facility | | $1,995.26 | $9,120.11 | $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
- $1,412.54 / $1,479.11 / $1,659.59
| Facility | | $1,412.54 | $1,479.11 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- 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 |