- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $312.31 / $954.86 / $2,585.73
| Facility | | $312.31 | $954.86 | $2,585.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $777.43 / $1,022.54 / $1,977.91
| Facility | | $777.43 | $1,022.54 | $1,977.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,756.50 / $1,756.50 / $1,756.50
| Facility | | $1,756.50 | $1,756.50 | $1,756.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.95 / $688.49 / $1,472.94
| Facility | | $300.95 | $688.49 | $1,472.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.07 / $692.41 / $1,101.56
| Facility | | $603.07 | $692.41 | $1,101.56 |