- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,698.24 / $8,709.64
| Facility | | $1,174.90 | $1,698.24 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $6,760.83 / $9,120.11
| Facility | | $6,760.83 | $6,760.83 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $3,630.78
| Facility | | $1,258.93 | $1,258.93 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $8,912.51
| Facility | | $8,912.51 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $5,495.41 / $14,454.40
| Facility | | $2,089.30 | $5,495.41 | $14,454.40 |