- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $4,786.30 / $8,317.64
| Facility | | $1,288.25 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $776.25 / $1,202.26
| Facility | | $575.44 | $776.25 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,698.24 / $16,218.10
| Facility | | $676.08 | $1,698.24 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,570.40 / $4,677.35
| Facility | | $1,548.82 | $2,570.40 | $4,677.35 |