- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $4,786.30 / $10,471.29
| Facility | | $1,202.26 | $4,786.30 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $8,511.38 / $8,912.51
| Facility | | $2,137.96 | $8,511.38 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $10,964.78 / $10,964.78
| Facility | | $501.19 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,148.15 / $13,182.57
| Facility | | $724.44 | $1,148.15 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $5,754.40 / $11,748.98
| Facility | | $2,818.38 | $5,754.40 | $11,748.98 |