- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,570.88 / $10,471.29
| Facility | | $1,698.24 | $4,570.88 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,380.38 / $2,187.76
| Facility | | $1,047.13 | $1,380.38 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $1,096.48 / $2,818.38
| Facility | | $457.09 | $1,096.48 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,174.90 / $1,778.28
| Facility | | $380.19 | $1,174.90 | $1,778.28 |