- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,248.07 / $9,120.11
| Facility | | $1,621.81 | $5,248.07 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,412.54 / $1,412.54
| Facility | | $1,318.26 | $1,412.54 | $1,412.54 |
- 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
- $776.25 / $1,230.27 / $6,918.31
| Facility | | $776.25 | $1,230.27 | $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 |