- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,503.12 / $7,458.15 / $14,000.85
| Facility | | $5,503.12 | $7,458.15 | $14,000.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.76 / $280.08 / $7,772.00
| Facility | | $157.76 | $280.08 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.39 / $402.08 / $3,054.91
| Facility | | $296.39 | $402.08 | $3,054.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |