- 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
- $8,430.26 / $12,221.51 / $21,447.95
| Facility | | $8,430.26 | $12,221.51 | $21,447.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.62 / $315.43 / $791.76
| Facility | | $153.62 | $315.43 | $791.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $351.50 / $672.94 / $1,497.11
| Facility | | $351.50 | $672.94 | $1,497.11 |
- 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 |