- 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
- $1,322.41 / $1,739.33 / $3,364.42
| Facility | | $1,322.41 | $1,739.33 | $3,364.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.68 / $1,190.90 / $1,839.59
| Facility | | $197.68 | $1,190.90 | $1,839.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.00 / $1,536.06 / $2,377.10
| Facility | | $369.00 | $1,536.06 | $2,377.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |