- 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
- $3,350.61 / $4,406.97 / $8,524.51
| Facility | | $3,350.61 | $4,406.97 | $8,524.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $869.14 / $1,521.00 / $3,726.00
| Facility | | $869.14 | $1,521.00 | $3,726.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.29 / $2,121.53 / $2,972.09
| Facility | | $1,110.29 | $2,121.53 | $2,972.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |