- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $4,241.22 / $13,841.56
| Facility | | $1,506.15 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,009.30 / $3,958.05 / $7,656.16
| Facility | | $3,009.30 | $3,958.05 | $7,656.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,387.40 / $1,387.40
| Facility | | $1,387.40 | $1,387.40 | $1,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.36 / $828.98 / $4,217.00
| Facility | | $467.36 | $828.98 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.00 / $1,150.65 / $1,757.37
| Facility | | $646.00 | $1,150.65 | $1,757.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,430.87 / $3,318.24 / $7,772.00
| Facility | | $2,430.87 | $3,318.24 | $7,772.00 |