- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $512.86 / $2,041.74
| Facility | | $467.74 | $512.86 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $870.96 / $2,290.87
| Facility | | $380.19 | $870.96 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,862.09 / $4,466.84
| Facility | | $1,318.26 | $1,862.09 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,778.28 / $3,548.13
| Facility | | $1,445.44 | $1,778.28 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $794.33 / $1,412.54
| Facility | | $467.74 | $794.33 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,819.70 / $3,467.37
| Facility | | $602.56 | $1,819.70 | $3,467.37 |