- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,090.30 / $6,309.57
| Facility | | $1,258.93 | $3,090.30 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $1,096.48 / $1,995.26
| Facility | | $416.87 | $1,096.48 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $707.95 / $1,174.90
| Facility | | $537.03 | $707.95 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $245.47 / $2,398.83
| Facility | | $162.18 | $245.47 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,862.09 / $4,677.35
| Facility | | $977.24 | $1,862.09 | $4,677.35 |