- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $10,471.29 / $18,197.01
| Facility | | $1,862.09 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,467.37 / $6,165.95
| Facility | | $1,862.09 | $3,467.37 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $1,995.26
| Facility | | $707.95 | $707.95 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $831.76 / $1,737.80
| Facility | | $660.69 | $831.76 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,964.78 / $16,982.44
| Facility | | $1,995.26 | $10,964.78 | $16,982.44 |