- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $5,011.87
| Facility | | $1,348.96 | $1,348.96 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $8,511.38 / $20,417.38
| Facility | | $4,466.84 | $8,511.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $4,897.79 / $11,748.98
| Facility | | $3,467.37 | $4,897.79 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $4,677.35 / $9,332.54
| Facility | | $3,801.89 | $4,677.35 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,754.23 / $6,918.31
| Facility | | $1,412.54 | $2,754.23 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $5,248.07 / $8,912.51
| Facility | | $1,584.89 | $5,248.07 | $8,912.51 |