- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,570.88 / $10,471.29
| Facility | | $1,698.24 | $4,570.88 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,630.78 / $5,754.40
| Facility | | $2,754.23 | $3,630.78 | $5,754.40 |
- 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
- $812.83 / $1,318.26 / $11,748.98
| Facility | | $812.83 | $1,318.26 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,248.07 / $8,912.51
| Facility | | $1,995.26 | $5,248.07 | $8,912.51 |