- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.31 / $3,250.33 / $6,101.70
| Facility | | $2,398.31 | $3,250.33 | $6,101.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.28 / $246.68 / $2,406.73
| Facility | | $153.28 | $246.68 | $2,406.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.86 / $349.03 / $497.43
| Facility | | $280.86 | $349.03 | $497.43 |
- 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 |