- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $4,570.88 / $10,715.19
| Facility | | $1,348.96 | $4,570.88 | $10,715.19 |
- 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
- $645.65 / $1,096.48 / $11,748.98
| Facility | | $645.65 | $1,096.48 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,248.07 / $8,912.51
| Facility | | $1,995.26 | $5,248.07 | $8,912.51 |