- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,668.15 / $24,068.03
| Facility | | $5,463.36 | $11,668.15 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,731.81 / $33,844.37 / $65,465.93
| Facility | | $25,731.81 | $33,844.37 | $65,465.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $819.05 / $1,279.19 / $9,164.54
| Facility | | $819.05 | $1,279.19 | $9,164.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,287.31 / $1,564.94 / $1,857.85
| Facility | | $1,287.31 | $1,564.94 | $1,857.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |