- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,311.31 / $7,943.28
| Facility | | $1,348.96 | $3,311.31 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,412.54 / $1,479.11
| Facility | | $575.44 | $1,412.54 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $870.96 / $2,454.71
| Facility | | $602.56 | $870.96 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $295.12 / $3,311.31
| Facility | | $177.83 | $295.12 | $3,311.31 |
- 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 |