- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,677.35 / $4,897.79
| Facility | | $2,344.23 | $4,677.35 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,125.38 / $19,054.61
| Facility | | $6,456.54 | $14,125.38 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,235.94 / $3,630.78
| Facility | | $3,090.30 | $3,235.94 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $5,623.41 / $5,623.41
| Facility | | $758.58 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,623.41 / $12,022.64
| Facility | | $1,023.29 | $5,623.41 | $12,022.64 |