- 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
- $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
- $192.37 / $631.01 / $4,293.37
| Facility | | $192.37 | $631.01 | $4,293.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.80 / $1,036.39 / $2,979.56
| Facility | | $388.80 | $1,036.39 | $2,979.56 |
- 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 |