- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,897.79 / $10,471.29
| Facility | | $1,513.56 | $4,897.79 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $7,413.10 / $8,128.31
| Facility | | $3,311.31 | $7,413.10 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $4,466.84
| Facility | | $912.01 | $912.01 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $870.96 / $3,981.07
| Facility | | $602.56 | $870.96 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $4,265.80 / $6,309.57
| Facility | | $1,778.28 | $4,265.80 | $6,309.57 |