- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,832.26 / $6,187.17 / $11,559.92
| Facility | | $1,832.26 | $6,187.17 | $11,559.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,460.86 / $4,943.77 / $8,777.32
| Facility | | $2,460.86 | $4,943.77 | $8,777.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $580.00 / $1,965.14
| Facility | | $580.00 | $580.00 | $1,965.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.00 / $707.98 / $999.50
| Facility | | $541.00 | $707.98 | $999.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $10,069.00 / $16,249.00
| Facility | | $1,981.00 | $10,069.00 | $16,249.00 |