- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $10,471.29 / $18,197.01
| Facility | | $2,137.96 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,888.44 / $10,964.78
| Facility | | $2,691.53 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $2,570.40
| Facility | | $707.95 | $707.95 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $954.99 / $1,698.24
| Facility | | $794.33 | $954.99 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $13,182.57 / $23,988.33
| Facility | | $2,137.96 | $13,182.57 | $23,988.33 |