- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,890.45 / $8,511.38
| Facility | | $2,238.72 | $3,890.45 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,445.44 / $1,445.44
| Facility | | $1,380.38 | $1,445.44 | $1,445.44 |
- 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
- $1,230.27 / $2,041.74 / $4,168.69
| Facility | | $1,230.27 | $2,041.74 | $4,168.69 |
- 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 |