- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,173.40 / $6,673.80 / $15,788.64
| Facility | | $1,173.40 | $6,673.80 | $15,788.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,991.19 / $10,798.84 / $19,132.41
| Facility | | $3,991.19 | $10,798.84 | $19,132.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $3,639.40 / $4,676.68
| Facility | | $715.00 | $3,639.40 | $4,676.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.12 / $550.20 / $969.56
| Facility | | $430.12 | $550.20 | $969.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |