- 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
- $217.37 / $519.64 / $1,058.24
| Facility | | $217.37 | $519.64 | $1,058.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.44 / $941.52 / $1,202.61
| Facility | | $485.44 | $941.52 | $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 |