- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $5,495.41
| Facility | | $2,884.03 | $4,466.84 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,884.03 / $7,413.10
| Facility | | $1,548.82 | $2,884.03 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $1,445.44
| Facility | | $1,445.44 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,754.23 / $4,570.88
| Facility | | $1,659.59 | $2,754.23 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $6,456.54 / $8,912.51
| Facility | | $4,677.35 | $6,456.54 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $5,495.41 / $12,302.69
| Facility | | $1,348.96 | $5,495.41 | $12,302.69 |