- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,533.80 / $2,223.57 / $3,902.23
| Facility | | $1,533.80 | $2,223.57 | $3,902.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.75 / $638.79 / $2,002.54
| Facility | | $79.75 | $638.79 | $2,002.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.47 / $1,458.21 / $2,082.60
| Facility | | $189.47 | $1,458.21 | $2,082.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,361.42 / $3,044.00 / $7,772.00
| Facility | | $2,361.42 | $3,044.00 | $7,772.00 |