- 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
- $5,279.80 / $7,654.23 / $13,432.67
| Facility | | $5,279.80 | $7,654.23 | $13,432.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.11 / $570.69 / $4,189.00
| Facility | | $326.11 | $570.69 | $4,189.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.44 / $932.54 / $3,282.67
| Facility | | $654.44 | $932.54 | $3,282.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |