- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,989.19 / $5,463.36 / $13,841.56
| Facility | | $1,989.19 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,020.60 / $5,448.94 / $10,229.04
| Facility | | $4,020.60 | $5,448.94 | $10,229.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.83 / $311.85 / $7,772.00
| Facility | | $146.83 | $311.85 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.94 / $374.70 / $3,093.19
| Facility | | $264.94 | $374.70 | $3,093.19 |
- 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 |