- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,463.36 / $13,841.56
| Facility | | $2,166.29 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,577.45 / $4,848.37 / $9,101.62
| Facility | | $3,577.45 | $4,848.37 | $9,101.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $928.27 / $1,624.47 / $7,465.26
| Facility | | $928.27 | $1,624.47 | $7,465.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,539.00 / $1,902.97 / $3,017.64
| Facility | | $1,539.00 | $1,902.97 | $3,017.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |