- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,463.36 / $13,841.56
| Facility | | $2,166.29 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,211.62 / $5,707.82 / $10,715.04
| Facility | | $4,211.62 | $5,707.82 | $10,715.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.51 / $480.98 / $3,728.65
| Facility | | $307.51 | $480.98 | $3,728.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.98 / $735.52 / $1,249.02
| Facility | | $548.98 | $735.52 | $1,249.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.88 / $3,093.00 / $7,934.00
| Facility | | $1,154.88 | $3,093.00 | $7,934.00 |