- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,466.08 / $4,241.22 / $13,841.56
| Facility | | $1,466.08 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,064.08 / $4,152.62 / $7,795.52
| Facility | | $3,064.08 | $4,152.62 | $7,795.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.44 / $235.32 / $2,398.48
| Facility | | $99.44 | $235.32 | $2,398.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.78 / $369.72 / $1,274.90
| Facility | | $179.78 | $369.72 | $1,274.90 |
- 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 |