- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $5,248.07 / $11,481.54
| Facility | | $1,445.44 | $5,248.07 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,041.74 / $3,235.94
| Facility | | $1,548.82 | $2,041.74 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $8,709.64 / $8,709.64
| Facility | | $501.19 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $954.99 / $6,918.31
| Facility | | $602.56 | $954.99 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,818.38 / $6,309.57
| Facility | | $1,862.09 | $2,818.38 | $6,309.57 |