- 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
- $1,507.81 / $2,043.47 / $3,836.12
| Facility | | $1,507.81 | $2,043.47 | $3,836.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $431.08 / $754.39 / $6,381.54
| Facility | | $431.08 | $754.39 | $6,381.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.69 / $1,086.57 / $1,757.37
| Facility | | $712.69 | $1,086.57 | $1,757.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,356.00 / $7,772.00
| Facility | | $3,711.00 | $5,356.00 | $7,772.00 |