- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,248.07 / $11,481.54
| Facility | | $1,023.29 | $5,248.07 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,073.80 / $4,570.88
| Facility | | $2,137.96 | $4,073.80 | $4,570.88 |
- 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
- $501.19 / $831.76 / $6,918.31
| Facility | | $501.19 | $831.76 | $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 |