- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $16,982.44 / $27,542.29
| Facility | | $3,467.37 | $16,982.44 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,258.93
| Facility | | $1,023.29 | $1,023.29 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $1,548.82 / $1,548.82
| Facility | | $1,548.82 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $53,703.18 / $102,329.30
| Facility | | $25,703.96 | $53,703.18 | $102,329.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $51,286.14
| Facility | | $12,882.50 | $12,882.50 | $51,286.14 |