- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $3,981.07 / $7,943.28
| Facility | | $1,071.52 | $3,981.07 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $4,265.80 / $6,165.95
| Facility | | $3,981.07 | $4,265.80 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,096.48 / $11,748.98
| Facility | | $660.69 | $1,096.48 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $5,248.07 / $8,912.51
| Facility | | $1,995.26 | $5,248.07 | $8,912.51 |