- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,879.03 / $4,241.22 / $13,841.56
| Facility | | $1,879.03 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,489.78 / $7,958.64 / $13,966.90
| Facility | | $5,489.78 | $7,958.64 | $13,966.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.08 / $663.14 / $913.70
| Facility | | $390.08 | $663.14 | $913.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.00 / $968.64 / $1,266.90
| Facility | | $646.00 | $968.64 | $1,266.90 |
- 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 |