- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $10,964.78 / $18,197.01
| Facility | | $3,019.95 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $8,511.38 / $15,848.93
| Facility | | $4,168.69 | $8,511.38 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $4,265.80
| Facility | | $707.95 | $707.95 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,348.96 / $2,344.23
| Facility | | $1,023.29 | $1,348.96 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $11,220.18 / $17,378.01
| Facility | | $1,995.26 | $11,220.18 | $17,378.01 |