- 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
- $1,322.41 / $1,792.20 / $3,364.42
| Facility | | $1,322.41 | $1,792.20 | $3,364.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.69 / $689.14 / $1,057.19
| Facility | | $159.69 | $689.14 | $1,057.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.98 / $1,006.62 / $1,474.70
| Facility | | $289.98 | $1,006.62 | $1,474.70 |
- 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 |