- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,786.30 / $8,317.64
| Facility | | $1,698.24 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,122.02 / $1,122.02
| Facility | | $1,071.52 | $1,122.02 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,288.25 / $5,623.41
| Facility | | $794.33 | $1,288.25 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,089.30 / $4,677.35
| Facility | | $1,445.44 | $2,089.30 | $4,677.35 |