- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,890.45 / $8,709.64
| Facility | | $1,445.44 | $3,890.45 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,585.78 / $7,943.28
| Facility | | $4,786.30 | $7,585.78 | $7,943.28 |
- 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
- $630.96 / $1,023.29 / $13,182.57
| Facility | | $630.96 | $1,023.29 | $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 |