- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.17 / $1,724.55 / $3,335.83
| Facility | | $1,311.17 | $1,724.55 | $3,335.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.75 / $588.16 / $5,564.75
| Facility | | $389.75 | $588.16 | $5,564.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $610.52 / $913.95 / $1,913.58
| Facility | | $610.52 | $913.95 | $1,913.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,510.02 / $2,707.88 / $7,772.00
| Facility | | $1,510.02 | $2,707.88 | $7,772.00 |