- 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
- $1,232.51 / $1,670.37 / $3,135.72
| Facility | | $1,232.51 | $1,670.37 | $3,135.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.78 / $300.51 / $907.20
| Facility | | $130.78 | $300.51 | $907.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.61 / $396.01 / $585.41
| Facility | | $250.61 | $396.01 | $585.41 |
- 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 |