- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $6,309.57 / $14,454.40
| Facility | | $2,089.30 | $6,309.57 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,511.89 / $2,511.89
| Facility | | $2,398.83 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $1,778.28 / $3,981.07
| Facility | | $1,778.28 | $1,778.28 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,819.70 / $10,964.78
| Facility | | $1,202.26 | $1,819.70 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $4,466.84 / $8,912.51
| Facility | | $1,949.84 | $4,466.84 | $8,912.51 |