- 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
- $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
- $176.23 / $299.58 / $1,467.76
| Facility | | $176.23 | $299.58 | $1,467.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.94 / $475.18 / $1,139.33
| Facility | | $336.94 | $475.18 | $1,139.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $919.26 / $3,093.00 / $7,934.00
| Facility | | $919.26 | $3,093.00 | $7,934.00 |