- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,398.83 / $4,897.79
| Facility | | $1,778.28 | $2,398.83 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $17,378.01 / $25,703.96
| Facility | | $8,317.64 | $17,378.01 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $1,737.80 / $1,819.70
| Facility | | $1,548.82 | $1,737.80 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,090.30 / $4,073.80
| Facility | | $1,698.24 | $3,090.30 | $4,073.80 |
- 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 |