- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,818.38 / $20,892.96
| Facility | | $2,041.74 | $2,818.38 | $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
- $1,023.29 / $1,949.84 / $2,754.23
| Facility | | $1,023.29 | $1,949.84 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,089.30 / $2,187.76
| Facility | | $1,548.82 | $2,089.30 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $1,479.11
| Facility | | $1,445.44 | $1,445.44 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,258.93 / $5,754.40
| Facility | | $707.95 | $1,258.93 | $5,754.40 |