- 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
- $3,896.99 / $5,281.43 / $9,914.59
| Facility | | $3,896.99 | $5,281.43 | $9,914.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.77 / $1,606.42 / $3,412.68
| Facility | | $294.77 | $1,606.42 | $3,412.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.70 / $1,828.48 / $2,800.41
| Facility | | $611.70 | $1,828.48 | $2,800.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |