- 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
- $57.93 / $98.48 / $289.13
| Facility | | $57.93 | $98.48 | $289.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.38 / $143.38 / $199.20
| Facility | | $115.38 | $143.38 | $199.20 |
- 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 |