- 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
- $5,121.08 / $7,424.13 / $13,028.86
| Facility | | $5,121.08 | $7,424.13 | $13,028.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.60 / $669.12 / $1,166.48
| Facility | | $393.60 | $669.12 | $1,166.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $785.84 / $1,005.90 / $2,440.29
| Facility | | $785.84 | $1,005.90 | $2,440.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |