- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $4,570.88 / $20,892.96
| Facility | | $2,818.38 | $4,570.88 | $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
- $1,862.09 / $3,311.31 / $4,570.88
| Facility | | $1,862.09 | $3,311.31 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,467.37 / $3,630.78
| Facility | | $2,570.40 | $3,467.37 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $2,511.89
| Facility | | $2,454.71 | $2,454.71 | $2,511.89 |
- 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 |