- 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
- $76.03 / $427.33 / $1,013.44
| Facility | | $76.03 | $427.33 | $1,013.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.67 / $932.56 / $1,270.34
| Facility | | $180.67 | $932.56 | $1,270.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,467.76 / $2,003.56 / $7,772.00
| Facility | | $1,467.76 | $2,003.56 | $7,772.00 |