- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $4,778.89 / $13,841.56
| Facility | | $1,653.00 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,099.31 / $6,706.99 / $12,973.48
| Facility | | $5,099.31 | $6,706.99 | $12,973.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.53 / $624.36 / $4,236.79
| Facility | | $356.53 | $624.36 | $4,236.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $618.75 / $954.67 / $2,197.38
| Facility | | $618.75 | $954.67 | $2,197.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |