- 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
- $252.37 / $1,608.80 / $3,155.27
| Facility | | $252.37 | $1,608.80 | $3,155.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.63 / $1,854.29 / $2,811.20
| Facility | | $516.63 | $1,854.29 | $2,811.20 |
- 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 |