- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,884.03 / $6,760.83
| Facility | | $1,318.26 | $2,884.03 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,445.44 / $2,691.53
| Facility | | $549.54 | $1,445.44 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $891.25 / $1,584.89
| Facility | | $741.31 | $891.25 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $295.12 / $2,454.71
| Facility | | $208.93 | $295.12 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,698.24 / $4,677.35
| Facility | | $977.24 | $1,698.24 | $4,677.35 |