- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,630.78 / $8,128.31
| Facility | | $1,348.96 | $3,630.78 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,380.38 / $2,187.76
| Facility | | $1,047.13 | $1,380.38 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Facility | | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $954.99 / $2,818.38
| Facility | | $457.09 | $954.99 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,174.90 / $1,778.28
| Facility | | $380.19 | $1,174.90 | $1,778.28 |