- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $407.38 / $407.38
| Facility | | $263.03 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,737.80 / $3,890.45
| Facility | | $954.99 | $1,737.80 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,548.82 / $3,630.78
| Facility | | $1,071.52 | $1,548.82 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,479.11 / $2,884.03
| Facility | | $1,174.90 | $1,479.11 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $537.03 / $1,445.44
| Facility | | $269.15 | $537.03 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,905.46 / $3,715.35
| Facility | | $1,096.48 | $1,905.46 | $3,715.35 |