- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $5,011.87 / $9,120.11
| Facility | | $2,187.76 | $5,011.87 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,398.83 / $4,265.80
| Facility | | $891.25 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,584.89 / $2,570.40
| Facility | | $724.44 | $1,584.89 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $389.05 / $3,630.78
| Facility | | $295.12 | $389.05 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,951.21 / $5,370.32
| Facility | | $1,949.84 | $2,951.21 | $5,370.32 |