- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,489.78 / $7,958.64 / $13,966.90
| Facility | | $5,489.78 | $7,958.64 | $13,966.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.21 / $842.82 / $1,220.73
| Facility | | $460.21 | $842.82 | $1,220.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $868.98 / $1,293.06 / $2,516.35
| Facility | | $868.98 | $1,293.06 | $2,516.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,138.10 / $3,093.00 / $7,934.00
| Facility | | $2,138.10 | $3,093.00 | $7,934.00 |