- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $4,241.22 / $13,841.56
| Facility | | $1,506.15 | $4,241.22 | $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
- $97.42 / $782.90 / $3,032.48
| Facility | | $97.42 | $782.90 | $3,032.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.72 / $1,145.54 / $1,813.25
| Facility | | $199.72 | $1,145.54 | $1,813.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,550.04 / $3,044.00 / $7,772.00
| Facility | | $2,550.04 | $3,044.00 | $7,772.00 |