- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,092.89 / $13,841.56
| Facility | | $2,166.29 | $5,092.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,668.81 / $6,768.46 / $11,878.21
| Facility | | $4,668.81 | $6,768.46 | $11,878.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.66 / $296.92 / $418.94
| Facility | | $174.66 | $296.92 | $418.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.20 / $442.90 / $1,555.47
| Facility | | $326.20 | $442.90 | $1,555.47 |
- 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 |