- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,309.11 / $2,095.00 / $8,763.29
| Facility | | $1,309.11 | $2,095.00 | $8,763.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,703.05 / $8,392.32 / $13,362.65
| Facility | | $2,703.05 | $8,392.32 | $13,362.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.31 / $131.31 / $1,656.16
| Facility | | $131.31 | $131.31 | $1,656.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $248.04 / $356.30
| Facility | | $112.20 | $248.04 | $356.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $6,599.00 / $7,158.00
| Facility | | $936.00 | $6,599.00 | $7,158.00 |