- 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
- $111.43 / $189.43 / $563.14
| Facility | | $111.43 | $189.43 | $563.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.50 / $276.51 / $381.69
| Facility | | $222.50 | $276.51 | $381.69 |
- 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 |