- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,463.36 / $13,841.56
| Facility | | $2,166.29 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,685.60 / $5,343.09 / $9,376.78
| Facility | | $3,685.60 | $5,343.09 | $9,376.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.79 / $246.38 / $448.70
| Facility | | $140.79 | $246.38 | $448.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.02 / $363.09 / $7,649.62
| Facility | | $283.02 | $363.09 | $7,649.62 |
- 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 |