- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $6,760.83
| Facility | | $1,023.29 | $1,023.29 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $7,244.36 / $20,417.38
| Facility | | $4,466.84 | $7,244.36 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,715.35 / $8,709.64
| Facility | | $2,570.40 | $3,715.35 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $3,548.13 / $6,918.31
| Facility | | $2,818.38 | $3,548.13 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,905.46 / $3,981.07
| Facility | | $1,047.13 | $1,905.46 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,715.35 / $7,079.46
| Facility | | $1,905.46 | $3,715.35 | $7,079.46 |