- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,011.87 / $8,317.64
| Facility | | $2,137.96 | $5,011.87 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,511.89 / $3,801.89
| Facility | | $776.25 | $2,511.89 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $5,248.07 / $5,248.07
| Facility | | $5,248.07 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $676.08 / $10,715.19
| Facility | | $446.68 | $676.08 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,079.46 / $10,964.78
| Facility | | $5,011.87 | $7,079.46 | $10,964.78 |