- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,623.41 / $11,481.54
| Facility | | $1,778.28 | $5,623.41 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,025.60 / $16,218.10
| Facility | | $2,511.89 | $6,025.60 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,772.37 / $14,791.08
| Facility | | $6,456.54 | $9,772.37 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,122.02 / $21,379.62
| Facility | | $602.56 | $1,122.02 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,677.35 / $11,220.18
| Facility | | $2,884.03 | $4,677.35 | $11,220.18 |