- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $7,244.36 / $16,595.87
| Facility | | $1,737.80 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $7,943.28 / $14,454.40
| Facility | | $3,162.28 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $2,089.30
| Facility | | $501.19 | $501.19 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $912.01 / $1,479.11
| Facility | | $645.65 | $912.01 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,442.29
| Facility | | $5,128.61 | $13,182.57 | $23,442.29 |