- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $12,589.25 / $61,659.50
| Facility | | $1,380.38 | $12,589.25 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $40,738.03 / $81,283.05
| Facility | | $7,585.78 | $40,738.03 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,202.26 / $1,380.38
| Facility | | $1,174.90 | $1,202.26 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,995.26 / $2,511.89
| Facility | | $1,202.26 | $1,995.26 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $20,417.38 / $31,622.78
| Facility | | $12,022.64 | $20,417.38 | $31,622.78 |