- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $2,344.23 / $4,897.79
| Facility | | $1,621.81 | $2,344.23 | $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
- $1,445.44 / $1,513.56 / $1,698.24
| Facility | | $1,445.44 | $1,513.56 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,630.27 / $2,630.27
| Facility | | $758.58 | $2,630.27 | $2,630.27 |
- 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 |