- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $4,778.89 / $13,841.56
| Facility | | $1,653.00 | $4,778.89 | $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
- $186.08 / $833.59 / $1,869.21
| Facility | | $186.08 | $833.59 | $1,869.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.30 / $1,620.25 / $2,424.52
| Facility | | $416.30 | $1,620.25 | $2,424.52 |
- 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 |