- 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
- $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
- $90.68 / $193.64 / $1,242.00
| Facility | | $90.68 | $193.64 | $1,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.68 / $249.64 / $349.36
| Facility | | $202.68 | $249.64 | $349.36 |
- 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 |