- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,365.16 / $30,199.52
| Facility | | $1,513.56 | $4,365.16 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $7,079.46 / $10,232.93
| Facility | | $3,467.37 | $7,079.46 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $12,302.69 / $21,379.62
| Facility | | $794.33 | $12,302.69 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $11,481.54 / $39,810.72
| Facility | | $4,466.84 | $11,481.54 | $39,810.72 |