- 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
- $96.11 / $168.76 / $256.02
| Facility | | $96.11 | $168.76 | $256.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.53 / $267.10 / $384.82
| Facility | | $211.53 | $267.10 | $384.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.76 / $413.28 / $4,317.00
| Facility | | $302.76 | $413.28 | $4,317.00 |