- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $9,120.11 / $16,595.87
| Facility | | $1,148.15 | $9,120.11 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $3,388.44 / $6,760.83
| Facility | | $1,412.54 | $3,388.44 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $549.54 / $1,071.52
| Facility | | $407.38 | $549.54 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $6,760.83 / $10,471.29
| Facility | | $1,479.11 | $6,760.83 | $10,471.29 |