- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $7,762.47 / $10,471.29
| Facility | | $4,897.79 | $7,762.47 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $7,244.36 / $7,244.36
| Facility | | $2,454.71 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $3,981.07 / $3,981.07
| Facility | | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $549.54 / $741.31
| Facility | | $407.38 | $549.54 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $6,456.54 / $12,302.69
| Facility | | $1,348.96 | $6,456.54 | $12,302.69 |