- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,801.89 / $8,511.38
| Facility | | $1,047.13 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,174.90 / $1,174.90
| Facility | | $1,122.02 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,096.48 / $4,365.16
| Facility | | $741.31 | $1,096.48 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,445.44 / $3,311.31
| Facility | | $1,023.29 | $1,445.44 | $3,311.31 |