- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,467.37 / $4,897.79
| Facility | | $1,348.96 | $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
- $831.76 / $870.96 / $977.24
| Facility | | $831.76 | $870.96 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,548.82 / $2,398.83
| Facility | | $870.96 | $1,548.82 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,754.40 / $12,022.64
| Facility | | $1,412.54 | $5,754.40 | $12,022.64 |