- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,691.53 / $6,606.93
| Facility | | $1,023.29 | $2,691.53 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,456.54 / $14,454.40
| Facility | | $3,388.44 | $6,456.54 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $1,148.15 / $1,148.15
| Facility | | $39.81 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $5,248.07 / $11,748.98
| Facility | | $870.96 | $5,248.07 | $11,748.98 |