- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,128.61 / $12,302.69
| Facility | | $1,778.28 | $5,128.61 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,897.79 / $9,549.93
| Facility | | $2,238.72 | $4,897.79 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $11,748.98 / $13,803.84
| Facility | | $2,089.30 | $11,748.98 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,715.35 / $26,302.68
| Facility | | $933.25 | $3,715.35 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,801.89 / $12,882.50
| Facility | | $2,454.71 | $3,801.89 | $12,882.50 |