- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $9,120.11 / $16,595.87
| Facility | | $1,479.11 | $9,120.11 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $7,585.78 / $14,125.38
| Facility | | $3,235.94 | $7,585.78 | $14,125.38 |
- 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
- $512.86 / $776.25 / $1,258.93
| Facility | | $512.86 | $776.25 | $1,258.93 |
- 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 |