- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $4,897.79 / $11,220.18
| Facility | | $1,258.93 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $11,481.54 / $19,054.61
| Facility | | $3,715.35 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $831.76 / $954.99
| Facility | | $758.58 | $831.76 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,318.26 / $1,905.46
| Facility | | $933.25 | $1,318.26 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $7,762.47 / $10,964.78
| Facility | | $2,691.53 | $7,762.47 | $10,964.78 |