- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $2,754.23 / $7,585.78
| Facility | | $489.78 | $2,754.23 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $954.99 / $1,479.11
| Facility | | $724.44 | $954.99 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $870.96
| Facility | | $602.56 | $602.56 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $537.03 / $2,187.76
| Facility | | $251.19 | $537.03 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,202.26 / $3,311.31
| Facility | | $831.76 | $1,202.26 | $3,311.31 |