- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $6,456.54 / $8,912.51
| Facility | | $2,238.72 | $6,456.54 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $5,370.32 / $7,943.28
| Facility | | $1,659.59 | $5,370.32 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $9,120.11 / $9,120.11
| Facility | | $9,120.11 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,089.30 / $10,715.19
| Facility | | $1,380.38 | $2,089.30 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $7,413.10 / $10,964.78
| Facility | | $5,495.41 | $7,413.10 | $10,964.78 |