- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.00 / $3,480.82 / $7,838.38
| Facility | | $1,047.00 | $3,480.82 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.61 / $8,392.32 / $13,362.65
| Facility | | $2,423.61 | $8,392.32 | $13,362.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.68 / $192.68 / $749.86
| Facility | | $192.68 | $192.68 | $749.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.59 / $193.53 / $250.25
| Facility | | $153.59 | $193.53 | $250.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.00 / $3,085.00 / $5,060.00
| Facility | | $755.00 | $3,085.00 | $5,060.00 |