- 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
- $176.39 / $308.68 / $496.70
| Facility | | $176.39 | $308.68 | $496.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $353.19 / $449.62 / $1,555.47
| Facility | | $353.19 | $449.62 | $1,555.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,679.00 / $3,167.00 / $7,934.00
| Facility | | $2,679.00 | $3,167.00 | $7,934.00 |