- 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
- $129.34 / $252.14 / $1,242.00
| Facility | | $129.34 | $252.14 | $1,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.17 / $341.96 / $503.70
| Facility | | $275.17 | $341.96 | $503.70 |
- 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 |