- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,160.13 / $4,241.22 / $13,841.56
| Facility | | $1,160.13 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,578.27 / $7,559.99 / $14,192.03
| Facility | | $5,578.27 | $7,559.99 | $14,192.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.61 / $233.77 / $3,412.68
| Facility | | $112.61 | $233.77 | $3,412.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.87 / $323.87 / $1,727.78
| Facility | | $208.87 | $323.87 | $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 |