- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,677.35 / $8,317.64
| Facility | | $2,089.30 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,511.89 / $3,801.89
| Facility | | $776.25 | $2,511.89 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $2,818.38
| Facility | | $2,818.38 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $630.96 / $3,801.89
| Facility | | $416.87 | $630.96 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,235.94 / $5,370.32
| Facility | | $2,238.72 | $3,235.94 | $5,370.32 |