- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,467.37 / $4,897.79
| Facility | | $1,584.89 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $25,118.86 / $31,622.78
| Facility | | $10,471.29 | $25,118.86 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $1,584.89 / $1,819.70
| Facility | | $1,548.82 | $1,584.89 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,238.72 / $3,388.44
| Facility | | $1,584.89 | $2,238.72 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $13,182.57 / $20,417.38
| Facility | | $6,456.54 | $13,182.57 | $20,417.38 |