- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $7,762.47 / $15,848.93
| Facility | | $1,659.59 | $7,762.47 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $6,918.31 / $12,882.50
| Facility | | $2,884.03 | $6,918.31 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,235.94 / $4,168.69
| Facility | | $501.19 | $3,235.94 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $891.25 / $1,412.54
| Facility | | $616.60 | $891.25 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |