- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $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
- $87.35 / $401.54 / $915.24
| Facility | | $87.35 | $401.54 | $915.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.04 / $466.32 / $721.01
| Facility | | $163.04 | $466.32 | $721.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |