- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,467.37 / $4,897.79
| Facility | | $1,380.38 | $3,467.37 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $21,379.62 / $27,542.29
| Facility | | $9,549.93 | $21,379.62 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,258.93
| Facility | | $1,148.15 | $1,148.15 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,174.90 / $1,288.25
| Facility | | $954.99 | $1,174.90 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,754.40 / $12,022.64
| Facility | | $1,412.54 | $5,754.40 | $12,022.64 |