- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $8,128.31 / $20,892.96
| Facility | | $2,570.40 | $8,128.31 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $707.95 / $954.99
| Facility | | $501.19 | $707.95 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,454.71 / $3,467.37
| Facility | | $1,380.38 | $2,454.71 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,630.27 / $2,754.23
| Facility | | $2,187.76 | $2,630.27 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,905.46
| Facility | | $1,862.09 | $1,862.09 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,570.40 / $8,317.64
| Facility | | $2,290.87 | $2,570.40 | $8,317.64 |