- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $4,241.22 / $13,841.56
| Facility | | $1,506.15 | $4,241.22 | $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
- $102.37 / $257.89 / $621.29
| Facility | | $102.37 | $257.89 | $621.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.32 / $596.79 / $1,107.68
| Facility | | $244.32 | $596.79 | $1,107.68 |
- 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 |