- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.25 / $4,182.08 / $13,841.56
| Facility | | $1,175.25 | $4,182.08 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,616.14 / $6,256.05 / $11,744.20
| Facility | | $4,616.14 | $6,256.05 | $11,744.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.71 / $552.36 / $2,552.80
| Facility | | $182.71 | $552.36 | $2,552.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.44 / $751.82 / $1,425.85
| Facility | | $368.44 | $751.82 | $1,425.85 |
- 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 |