- 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
- $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
- $278.01 / $486.52 / $995.20
| Facility | | $278.01 | $486.52 | $995.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $557.72 / $796.11 / $1,212.29
| Facility | | $557.72 | $796.11 | $1,212.29 |
- 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 |