- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,890.45 / $7,762.47
| Facility | | $1,288.25 | $3,890.45 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,912.51 / $14,454.40
| Facility | | $5,623.41 | $8,912.51 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $1,949.84
| Facility | | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,479.11 / $6,025.60
| Facility | | $933.25 | $1,479.11 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,089.30 / $4,073.80
| Facility | | $645.65 | $2,089.30 | $4,073.80 |