- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,897.79 / $16,595.87
| Facility | | $1,288.25 | $4,897.79 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,754.40 / $10,471.29
| Facility | | $2,344.23 | $5,754.40 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $2,089.30
| Facility | | $371.54 | $371.54 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $676.08 / $1,096.48
| Facility | | $478.63 | $676.08 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $16,982.44
| Facility | | $2,754.23 | $11,220.18 | $16,982.44 |