- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,495.41 / $10,471.29
| Facility | | $1,778.28 | $5,495.41 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $5,128.61 / $5,370.32
| Facility | | $1,862.09 | $5,128.61 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $8,709.64 / $8,709.64
| Facility | | $630.96 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,621.81 / $8,317.64
| Facility | | $1,047.13 | $1,621.81 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $5,754.40 / $11,748.98
| Facility | | $2,818.38 | $5,754.40 | $11,748.98 |