- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $2,398.83
| Facility | | $1,412.54 | $1,412.54 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $14,454.40 / $36,307.81
| Facility | | $3,311.31 | $14,454.40 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,698.24
| Facility | | $1,412.54 | $1,412.54 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $14,791.08 / $36,307.81
| Facility | | $3,630.78 | $14,791.08 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $18,197.01 / $40,738.03
| Facility | | $1,047.13 | $18,197.01 | $40,738.03 |