- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,890.45 / $7,585.78
| Facility | | $1,445.44 | $3,890.45 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,778.28 / $3,019.95
| Facility | | $630.96 | $1,778.28 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,445.44 / $2,570.40
| Facility | | $512.86 | $1,445.44 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $549.54 / $2,398.83
| Facility | | $371.54 | $549.54 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,951.21 / $5,370.32
| Facility | | $851.14 | $2,951.21 | $5,370.32 |