- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,570.88 / $10,471.29
| Facility | | $1,380.38 | $4,570.88 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,905.46 / $1,905.46
| Facility | | $1,819.70 | $1,905.46 | $1,905.46 |
- 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
- $660.69 / $1,023.29 / $6,918.31
| Facility | | $660.69 | $1,023.29 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,818.38 / $6,309.57
| Facility | | $1,862.09 | $2,818.38 | $6,309.57 |