- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,912.51 / $16,595.87
| Facility | | $2,630.27 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,365.16 / $8,128.31
| Facility | | $2,089.30 | $4,365.16 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $2,137.96 / $2,754.23
| Facility | | $812.83 | $2,137.96 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $371.54 / $602.56
| Facility | | $245.47 | $371.54 | $602.56 |
- 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 |