- 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
- $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
- $391.37 / $651.16 / $4,217.00
| Facility | | $391.37 | $651.16 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.99 / $986.87 / $2,440.29
| Facility | | $729.99 | $986.87 | $2,440.29 |
- 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 |