- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,388.44 / $7,762.47
| Facility | | $1,096.48 | $3,388.44 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $12,022.64
| Facility | | $5,011.87 | $8,511.38 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $1,348.96 / $1,348.96
| Facility | | $39.81 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $812.83 / $2,570.40
| Facility | | $489.78 | $812.83 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,174.90 / $5,754.40
| Facility | | $371.54 | $1,174.90 | $5,754.40 |