- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $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
- $232.47 / $886.54 / $2,480.90
| Facility | | $232.47 | $886.54 | $2,480.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $565.12 / $1,751.19 / $3,032.25
| Facility | | $565.12 | $1,751.19 | $3,032.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,361.42 / $3,044.00 / $7,772.00
| Facility | | $2,361.42 | $3,044.00 | $7,772.00 |