- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,463.36 / $13,841.56
| Facility | | $2,166.29 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,455.14 / $2,109.54 / $3,702.11
| Facility | | $1,455.14 | $2,109.54 | $3,702.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.38 / $33.92 / $62.49
| Facility | | $19.38 | $33.92 | $62.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.79 / $46.58 / $67.78
| Facility | | $38.79 | $46.58 | $67.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |