- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,124.24 / $4,778.89 / $13,841.56
| Facility | | $1,124.24 | $4,778.89 | $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
- $375.31 / $667.33 / $4,217.00
| Facility | | $375.31 | $667.33 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.00 / $1,010.91 / $1,757.37
| Facility | | $716.00 | $1,010.91 | $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 |