- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,897.79 / $11,220.18
| Facility | | $1,071.52 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $13,803.84 / $19,054.61
| Facility | | $3,715.35 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $724.44 / $812.83
| Facility | | $645.65 | $724.44 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,096.48 / $1,778.28
| Facility | | $794.33 | $1,096.48 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,715.35 / $6,456.54
| Facility | | $2,398.83 | $3,715.35 | $6,456.54 |