- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,025.60 / $13,489.63
| Facility | | $2,511.89 | $6,025.60 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $6,309.57 / $13,182.57
| Facility | | $2,344.23 | $6,309.57 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $11,748.98 / $22,908.68
| Facility | | $8,709.64 | $11,748.98 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,630.78 / $26,302.68
| Facility | | $660.69 | $3,630.78 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,365.16 / $11,220.18
| Facility | | $2,884.03 | $4,365.16 | $11,220.18 |