- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $7,943.28 / $20,892.96
| Facility | | $1,445.44 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $933.25 / $1,995.26
| Facility | | $891.25 | $933.25 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,258.93 / $2,290.87
| Facility | | $812.83 | $1,258.93 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,445.44 / $1,548.82
| Facility | | $1,148.15 | $1,445.44 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,047.13
| Facility | | $1,023.29 | $1,023.29 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $4,570.88 / $8,709.64
| Facility | | $3,467.37 | $4,570.88 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,623.41 / $10,964.78
| Facility | | $1,995.26 | $5,623.41 | $10,964.78 |