- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $5,495.41 / $6,918.31
| Facility | | $3,890.45 | $5,495.41 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,890.45 / $8,317.64
| Facility | | $1,737.80 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $1,659.59
| Facility | | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,230.27 / $2,089.30
| Facility | | $691.83 | $1,230.27 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $7,244.36 / $10,232.93
| Facility | | $5,248.07 | $7,244.36 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $5,495.41 / $12,302.69
| Facility | | $1,348.96 | $5,495.41 | $12,302.69 |