- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,668.81 / $6,768.46 / $11,878.21
| Facility | | $4,668.81 | $6,768.46 | $11,878.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.49 / $384.11 / $677.48
| Facility | | $219.49 | $384.11 | $677.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $440.51 / $601.47 / $1,522.92
| Facility | | $440.51 | $601.47 | $1,522.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |