- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $6,025.60 / $16,595.87
| Facility | | $1,023.29 | $6,025.60 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $5,495.41 / $10,232.93
| Facility | | $2,290.87 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,715.35 / $4,786.30
| Facility | | $501.19 | $3,715.35 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $933.25 / $1,819.70
| Facility | | $645.65 | $933.25 | $1,819.70 |
- 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 |