- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,623.41 / $10,471.29
| Facility | | $2,041.74 | $5,623.41 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,630.78 / $5,754.40
| Facility | | $2,754.23 | $3,630.78 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,819.70 / $6,456.54
| Facility | | $1,047.13 | $1,819.70 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,168.69 / $8,912.51
| Facility | | $645.65 | $4,168.69 | $8,912.51 |