- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $4,365.16 / $8,511.38
| Facility | | $1,258.93 | $4,365.16 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $5,248.07 / $5,495.41
| Facility | | $575.44 | $5,248.07 | $5,495.41 |
- 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
- $691.83 / $1,096.48 / $3,801.89
| Facility | | $691.83 | $1,096.48 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,290.87 / $4,677.35
| Facility | | $1,548.82 | $2,290.87 | $4,677.35 |