- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $3,630.78 / $7,762.47
| Facility | | $2,089.30 | $3,630.78 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,445.44 / $2,691.53
| Facility | | $549.54 | $1,445.44 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $7,943.28 / $13,182.57
| Facility | | $6,025.60 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $549.54 / $5,495.41
| Facility | | $389.05 | $549.54 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,365.16 / $9,332.54
| Facility | | $1,412.54 | $4,365.16 | $9,332.54 |