- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,698.24 / $4,168.69
| Facility | | $512.86 | $1,698.24 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $676.08
| Facility | | $562.34 | $562.34 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $1,862.09
| Facility | | $912.01 | $912.01 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $7,244.36 / $7,244.36
| Facility | | $7,244.36 | $7,244.36 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $2,454.71 / $9,120.11
| Facility | | $2,454.71 | $2,454.71 | $9,120.11 |