- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $10,471.29 / $18,197.01
| Facility | | $1,905.46 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,888.44 / $10,964.78
| Facility | | $2,691.53 | $5,888.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $1,659.59
| Facility | | $707.95 | $707.95 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $851.14 / $1,737.80
| Facility | | $676.08 | $851.14 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $10,964.78 / $16,982.44
| Facility | | $1,995.26 | $10,964.78 | $16,982.44 |