- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,890.45 / $7,762.47
| Facility | | $1,737.80 | $3,890.45 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,659.59 / $3,019.95
| Facility | | $630.96 | $1,659.59 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,584.89 / $2,570.40
| Facility | | $512.86 | $1,584.89 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $891.25 / $4,897.79
| Facility | | $691.83 | $891.25 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,890.45 / $7,244.36
| Facility | | $2,344.23 | $3,890.45 | $7,244.36 |