- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,630.78 / $20,892.96
| Facility | | $2,570.40 | $3,630.78 | $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
- $1,445.44 / $2,511.89 / $3,630.78
| Facility | | $1,445.44 | $2,511.89 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,630.27 / $2,818.38
| Facility | | $2,290.87 | $2,630.27 | $2,818.38 |
- 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
- $707.95 / $1,258.93 / $5,754.40
| Facility | | $707.95 | $1,258.93 | $5,754.40 |