- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $10,715.19 / $16,595.87
| Facility | | $5,248.07 | $10,715.19 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $6,456.54 / $15,848.93
| Facility | | $1,949.84 | $6,456.54 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $5,623.41
| Facility | | $812.83 | $812.83 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,412.54 / $2,818.38
| Facility | | $1,096.48 | $1,412.54 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $17,378.01 / $25,703.96
| Facility | | $2,884.03 | $17,378.01 | $25,703.96 |