- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $12,302.69 / $22,387.21
| Facility | | $2,884.03 | $12,302.69 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $27,542.29 / $51,286.14
| Facility | | $10,232.93 | $27,542.29 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $12,882.50
| Facility | | $12,882.50 | $12,882.50 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,288.25 / $2,344.23
| Facility | | $575.44 | $1,288.25 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $22,387.21 / $37,153.52
| Facility | | $8,317.64 | $22,387.21 | $37,153.52 |