- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $5,623.41 / $14,454.40
| Facility | | $1,348.96 | $5,623.41 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,801.89 / $5,248.07
| Facility | | $2,454.71 | $3,801.89 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $8,709.64 / $8,709.64
| Facility | | $977.24 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,023.29 / $11,748.98
| Facility | | $645.65 | $1,023.29 | $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 |