- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,100.60 / $4,495.00 / $7,888.43
| Facility | | $3,100.60 | $4,495.00 | $7,888.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.28 / $717.42 / $2,343.62
| Facility | | $115.28 | $717.42 | $2,343.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.74 / $1,503.09 / $2,370.64
| Facility | | $224.74 | $1,503.09 | $2,370.64 |
- 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 |