- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,570.88 / $10,471.29
| Facility | | $2,398.83 | $4,570.88 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $831.76
| Facility | | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,570.40 / $4,466.84
| Facility | | $1,513.56 | $2,570.40 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $2,089.30 / $4,677.35
| Facility | | $1,174.90 | $2,089.30 | $4,677.35 |