- 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
- $6,478.60 / $8,521.12 / $16,482.62
| Facility | | $6,478.60 | $8,521.12 | $16,482.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.12 / $169.20 / $2,040.62
| Facility | | $100.12 | $169.20 | $2,040.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.13 / $257.64 / $1,583.32
| Facility | | $175.13 | $257.64 | $1,583.32 |
- 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 |