- 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
- $4,973.60 / $6,740.51 / $12,653.65
| Facility | | $4,973.60 | $6,740.51 | $12,653.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.46 / $193.96 / $2,710.90
| Facility | | $103.46 | $193.96 | $2,710.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.71 / $273.87 / $917.51
| Facility | | $185.71 | $273.87 | $917.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |