- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $10,964.78 / $18,197.01
| Facility | | $2,238.72 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,677.35 / $8,128.31
| Facility | | $1,819.70 | $4,677.35 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $3,981.07 / $3,981.07
| Facility | | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,174.90 / $1,905.46
| Facility | | $776.25 | $1,174.90 | $1,905.46 |
- 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 |