- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $3,908.01 / $13,841.56
| Facility | | $1,506.15 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,665.88 / $3,864.78 / $6,782.44
| Facility | | $2,665.88 | $3,864.78 | $6,782.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86.76 / $297.20 / $719.69
| Facility | | $86.76 | $297.20 | $719.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.18 / $662.29 / $995.61
| Facility | | $208.18 | $662.29 | $995.61 |
- 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 |