- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,545.00 / $5,055.71 / $13,841.56
| Facility | | $1,545.00 | $5,055.71 | $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
- $166.24 / $429.10 / $923.80
| Facility | | $166.24 | $429.10 | $923.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $401.69 / $825.74 / $1,202.61
| Facility | | $401.69 | $825.74 | $1,202.61 |
- 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 |