- 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
- $1,917.24 / $2,521.69 / $4,877.78
| Facility | | $1,917.24 | $2,521.69 | $4,877.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.19 / $130.04 / $379.97
| Facility | | $76.19 | $130.04 | $379.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $152.28 / $189.24 / $261.75
| Facility | | $152.28 | $189.24 | $261.75 |
- 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 |