- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,866.90 / $4,241.22 / $13,841.56
| Facility | | $1,866.90 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.46 / $5,901.02 / $10,355.91
| Facility | | $4,070.46 | $5,901.02 | $10,355.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.55 / $264.44 / $1,207.19
| Facility | | $155.55 | $264.44 | $1,207.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.08 / $418.55 / $1,139.33
| Facility | | $287.08 | $418.55 | $1,139.33 |
- 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 |