- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.17 / $5,463.36 / $13,841.56
| Facility | | $1,456.17 | $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
- $388.12 / $662.50 / $1,141.27
| Facility | | $388.12 | $662.50 | $1,141.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $806.57 / $1,238.74 / $2,360.86
| Facility | | $806.57 | $1,238.74 | $2,360.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |