- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,533.80 / $2,223.57 / $3,902.23
| Facility | | $1,533.80 | $2,223.57 | $3,902.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.53 / $462.89 / $902.64
| Facility | | $88.53 | $462.89 | $902.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.60 / $896.86 / $1,182.97
| Facility | | $228.60 | $896.86 | $1,182.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |