- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $7,762.47 / $16,595.87
| Facility | | $1,230.27 | $7,762.47 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $5,248.07 / $9,772.37
| Facility | | $2,238.72 | $5,248.07 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,949.84 / $2,511.89
| Facility | | $501.19 | $1,949.84 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $602.56 / $1,071.52
| Facility | | $446.68 | $602.56 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $17,378.01
| Facility | | $2,754.23 | $11,220.18 | $17,378.01 |