- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $5,495.41 / $12,302.69
| Facility | | $1,584.89 | $5,495.41 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $4,265.80 / $4,365.16
| Facility | | $4,073.80 | $4,265.80 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $5,623.41 / $5,623.41
| Facility | | $630.96 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,202.26 / $11,748.98
| Facility | | $758.58 | $1,202.26 | $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 |