- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,677.35 / $8,317.64
| Facility | | $2,137.96 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $1,258.93 / $1,905.46
| Facility | | $389.05 | $1,258.93 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $851.14 / $851.14
| Facility | | $776.25 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $616.60 / $2,041.74
| Facility | | $131.83 | $616.60 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,202.26 / $2,187.76
| Facility | | $630.96 | $1,202.26 | $2,187.76 |