- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,715.35 / $7,943.28
| Facility | | $1,584.89 | $3,715.35 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,445.44 / $2,691.53
| Facility | | $549.54 | $1,445.44 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,754.23 / $5,011.87
| Facility | | $446.68 | $2,754.23 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $602.56 / $3,630.78
| Facility | | $407.38 | $602.56 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,388.44 / $5,370.32
| Facility | | $1,949.84 | $3,388.44 | $5,370.32 |