- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,570.88 / $10,471.29
| Facility | | $1,380.38 | $4,570.88 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $2,344.23
| Facility | | $912.01 | $912.01 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $870.96 / $6,309.57
| Facility | | $588.84 | $870.96 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,884.03 / $6,309.57
| Facility | | $1,778.28 | $2,884.03 | $6,309.57 |