- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,064.08 / $4,030.10 / $7,795.52
| Facility | | $3,064.08 | $4,030.10 | $7,795.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.99 / $388.93 / $3,586.95
| Facility | | $260.99 | $388.93 | $3,586.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.47 / $618.39 / $1,207.40
| Facility | | $409.47 | $618.39 | $1,207.40 |
- 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 |