- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,890.45 / $7,762.47
| Facility | | $1,288.25 | $3,890.45 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $9,120.11 / $14,454.40
| Facility | | $5,754.40 | $9,120.11 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,862.09 / $6,760.83
| Facility | | $1,023.29 | $1,862.09 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,311.31 / $6,165.95
| Facility | | $933.25 | $3,311.31 | $6,165.95 |