- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $896.47 / $4,241.22 / $13,841.56
| Facility | | $896.47 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,198.33 / $7,045.08 / $13,225.41
| Facility | | $5,198.33 | $7,045.08 | $13,225.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.94 / $248.10 / $3,032.48
| Facility | | $145.94 | $248.10 | $3,032.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.69 / $368.29 / $1,727.78
| Facility | | $295.69 | $368.29 | $1,727.78 |
- 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 |