- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $7,960.15
| Facility | | $1,671.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.59 / $4,605.95 / $8,070.83
| Facility | | $1,233.59 | $4,605.95 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,480.55 / $3,280.17 / $5,374.52
| Facility | | $2,480.55 | $3,280.17 | $5,374.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.37 / $629.21 / $6,014.00
| Facility | | $503.37 | $629.21 | $6,014.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,350.00 / $6,230.00 / $9,010.00
| Facility | | $2,350.00 | $6,230.00 | $9,010.00 |