- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,754.23 / $5,623.41
| Facility | | $1,047.13 | $2,754.23 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $1,096.48 / $1,995.26
| Facility | | $416.87 | $1,096.48 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $645.65 / $741.31
| Facility | | $537.03 | $645.65 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $398.11 / $1,548.82
| Facility | | $165.96 | $398.11 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,698.24 / $4,677.35
| Facility | | $977.24 | $1,698.24 | $4,677.35 |