- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $9,120.11 / $16,595.87
| Facility | | $1,288.25 | $9,120.11 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,623.41 / $10,471.29
| Facility | | $2,691.53 | $5,623.41 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,089.30 / $2,691.53
| Facility | | $575.44 | $2,089.30 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $660.69 / $1,096.48
| Facility | | $478.63 | $660.69 | $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 |