- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $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
- $235.79 / $412.63 / $783.19
| Facility | | $235.79 | $412.63 | $783.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.12 / $671.36 / $1,193.67
| Facility | | $473.12 | $671.36 | $1,193.67 |
- 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 |