- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,514.19 / $3,306.85 / $6,396.51
| Facility | | $2,514.19 | $3,306.85 | $6,396.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.31 / $521.37 / $1,242.00
| Facility | | $39.31 | $521.37 | $1,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.71 / $548.04 / $966.84
| Facility | | $91.71 | $548.04 | $966.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |