- 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
- $139.60 / $750.67 / $2,132.94
| Facility | | $139.60 | $750.67 | $2,132.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.90 / $1,497.11 / $2,578.92
| Facility | | $352.90 | $1,497.11 | $2,578.92 |
- 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 |