- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,441.02 / $6,107.18 / $19,602.33
| Facility | | $1,441.02 | $6,107.18 | $19,602.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.33 / $346.36 / $377.35
| Facility | | $312.33 | $346.36 | $377.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.81 / $500.81 / $500.81
| Facility | | $500.81 | $500.81 | $500.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,338.91 / $8,247.90 / $10,492.32
| Facility | | $3,338.91 | $8,247.90 | $10,492.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $2,450.00 / $2,450.00
| Facility | | $2,450.00 | $2,450.00 | $2,450.00 |