- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,380.38 / $7,762.47
| Facility | | $1,258.93 | $1,380.38 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $9,772.37 / $15,488.17
| Facility | | $2,754.23 | $9,772.37 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $1,995.26
| Facility | | $1,445.44 | $1,445.44 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,071.52 / $1,949.84
| Facility | | $794.33 | $1,071.52 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $7,762.47 / $15,488.17
| Facility | | $794.33 | $7,762.47 | $15,488.17 |