- 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
- $3,335.87 / $4,387.57 / $8,486.99
| Facility | | $3,335.87 | $4,387.57 | $8,486.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.54 / $1,444.95 / $3,331.88
| Facility | | $661.54 | $1,444.95 | $3,331.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,460.00 / $1,743.97 / $2,242.25
| Facility | | $1,460.00 | $1,743.97 | $2,242.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |