- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,691.53 / $6,606.93
| Facility | | $1,023.29 | $2,691.53 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,244.36 / $13,803.84
| Facility | | $4,073.80 | $7,244.36 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $1,412.54 / $1,412.54
| Facility | | $39.81 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,370.32 / $11,748.98
| Facility | | $1,148.15 | $5,370.32 | $11,748.98 |