- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,454.71 / $6,456.54
| Facility | | $1,096.48 | $2,454.71 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $5,888.44 / $9,772.37
| Facility | | $2,290.87 | $5,888.44 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $512.86 / $1,348.96
| Facility | | $501.19 | $512.86 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $7,244.36 / $7,244.36
| Facility | | $54.95 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,548.13 / $6,025.60
| Facility | | $1,258.93 | $3,548.13 | $6,025.60 |