- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,355.33 / $16,762.57
| Facility | | $4,083.97 | $8,355.33 | $16,762.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,099.31 / $6,706.99 / $12,973.48
| Facility | | $5,099.31 | $6,706.99 | $12,973.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.85 / $999.05 / $4,236.79
| Facility | | $505.85 | $999.05 | $4,236.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $892.26 / $1,324.82 / $2,197.38
| Facility | | $892.26 | $1,324.82 | $2,197.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |