- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.14 / $781.45 / $1,511.58
| Facility | | $594.14 | $781.45 | $1,511.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.10 / $387.83 / $994.74
| Facility | | $185.10 | $387.83 | $994.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.91 / $424.61 / $641.12
| Facility | | $186.91 | $424.61 | $641.12 |
- 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 |