- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $11,220.18 / $31,622.78
| Facility | | $1,778.28 | $11,220.18 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $8,912.51 / $16,595.87
| Facility | | $3,548.13 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $3,801.89
| Facility | | $707.95 | $707.95 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $977.24 / $1,778.28
| Facility | | $691.83 | $977.24 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $25,703.96
| Facility | | $8,709.64 | $20,417.38 | $25,703.96 |