- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,265.80 / $8,511.38
| Facility | | $1,698.24 | $4,265.80 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $8,912.51
| Facility | | $2,238.72 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $2,511.89
| Facility | | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,380.38 / $3,388.44
| Facility | | $891.25 | $1,380.38 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,019.95 / $6,606.93
| Facility | | $2,137.96 | $3,019.95 | $6,606.93 |