- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $3,908.01 / $12,765.09
| Facility | | $1,506.15 | $3,908.01 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,312.63 / $3,041.74 / $5,883.72
| Facility | | $2,312.63 | $3,041.74 | $5,883.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.66 / $246.99 / $3,044.00
| Facility | | $140.66 | $246.99 | $3,044.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.00 / $415.54 / $1,597.11
| Facility | | $269.00 | $415.54 | $1,597.11 |
- 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 |