- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- 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
- $196.98 / $704.31 / $1,568.77
| Facility | | $196.98 | $704.31 | $1,568.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.81 / $1,382.05 / $1,970.99
| Facility | | $495.81 | $1,382.05 | $1,970.99 |
- 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 |