- 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
- $3,551.47 / $5,148.63 / $9,035.51
| Facility | | $3,551.47 | $5,148.63 | $9,035.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.87 / $623.94 / $986.39
| Facility | | $356.87 | $623.94 | $986.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.00 / $1,034.08 / $2,308.06
| Facility | | $740.00 | $1,034.08 | $2,308.06 |
- 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 |