- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $12,022.64 / $18,197.01
| Facility | | $2,137.96 | $12,022.64 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $7,079.46 / $12,302.69
| Facility | | $3,630.78 | $7,079.46 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $1,995.26
| Facility | | $1,122.02 | $1,122.02 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $954.99 / $1,949.84
| Facility | | $758.58 | $954.99 | $1,949.84 |
- 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 |