- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,753.00 / $13,841.56
| Facility | | $2,318.31 | $5,753.00 | $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
- $181.43 / $332.80 / $1,033.04
| Facility | | $181.43 | $332.80 | $1,033.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.23 / $591.48 / $1,522.92
| Facility | | $366.23 | $591.48 | $1,522.92 |
- 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 |