- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $898.23 / $1,181.41 / $2,285.23
| Facility | | $898.23 | $1,181.41 | $2,285.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.45 / $418.40 / $2,000.00
| Facility | | $177.45 | $418.40 | $2,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $321.58 / $425.77 / $516.67
| Facility | | $321.58 | $425.77 | $516.67 |
- 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 |