- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,495.41 / $12,022.64
| Facility | | $1,023.29 | $5,495.41 | $12,022.64 |
- 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
- $11,481.54 / $11,481.54 / $11,481.54
| Facility | | $11,481.54 | $11,481.54 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,584.89 / $26,302.68
| Facility | | $724.44 | $1,584.89 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,754.23 / $4,677.35
| Facility | | $1,548.82 | $2,754.23 | $4,677.35 |