- 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
- $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
- $179.91 / $314.83 / $499.22
| Facility | | $179.91 | $314.83 | $499.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.40 / $453.19 / $1,622.05
| Facility | | $362.40 | $453.19 | $1,622.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,415.04 / $3,093.00 / $7,772.00
| Facility | | $2,415.04 | $3,093.00 | $7,772.00 |