- 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
- $110.37 / $206.16 / $2,108.55
| Facility | | $110.37 | $206.16 | $2,108.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.19 / $287.04 / $706.33
| Facility | | $195.19 | $287.04 | $706.33 |
- 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 |