- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $4,865.47 / $13,841.56
| Facility | | $2,318.31 | $4,865.47 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,608.94 / $2,180.53 / $4,093.41
| Facility | | $1,608.94 | $2,180.53 | $4,093.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.06 / $225.97 / $7,772.00
| Facility | | $104.06 | $225.97 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.12 / $260.81 / $3,093.19
| Facility | | $195.12 | $260.81 | $3,093.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,957.96 / $4,706.76 / $7,772.00
| Facility | | $3,957.96 | $4,706.76 | $7,772.00 |