- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $4,778.89 / $13,841.56
| Facility | | $2,318.31 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,489.78 / $7,958.64 / $13,966.90
| Facility | | $5,489.78 | $7,958.64 | $13,966.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.20 / $690.54 / $3,413.81
| Facility | | $406.20 | $690.54 | $3,413.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.54 / $1,086.60 / $2,532.54
| Facility | | $814.54 | $1,086.60 | $2,532.54 |
- 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 |