- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $3,162.28 / $13,803.84
| Facility | | $1,202.26 | $3,162.28 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,715.19 / $11,220.18
| Facility | | $6,606.93 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,584.89 / $2,238.72
| Facility | | $1,288.25 | $1,584.89 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,570.40 / $2,570.40
| Facility | | $34.67 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $4,168.69 / $30,199.52
| Facility | | $407.38 | $4,168.69 | $30,199.52 |