- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $6,309.57 / $14,454.40
| Facility | | $1,778.28 | $6,309.57 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $3,467.37 / $3,548.13
| Facility | | $3,311.31 | $3,467.37 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $977.24 / $977.24
| Facility | | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,202.26 / $11,748.98
| Facility | | $758.58 | $1,202.26 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,677.35 / $8,912.51
| Facility | | $1,995.26 | $4,677.35 | $8,912.51 |