- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,252.94 / $3,266.13 / $5,731.84
| Facility | | $2,252.94 | $3,266.13 | $5,731.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94.68 / $165.69 / $245.36
| Facility | | $94.68 | $165.69 | $245.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.68 / $243.50 / $906.10
| Facility | | $188.68 | $243.50 | $906.10 |
- 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 |