- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,715.35 / $6,760.83
| Facility | | $1,584.89 | $3,715.35 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,778.28 / $2,691.53
| Facility | | $549.54 | $1,778.28 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $602.56 / $602.56
| Facility | | $251.19 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $794.33 / $5,128.61
| Facility | | $316.23 | $794.33 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,019.95 / $5,370.32
| Facility | | $1,995.26 | $3,019.95 | $5,370.32 |