- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,630.27 / $8,511.38
| Facility | | $1,122.02 | $2,630.27 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,819.70 / $4,168.69
| Facility | | $676.08 | $1,819.70 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $1,659.59 / $1,659.59
| Facility | | $1,659.59 | $1,659.59 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,071.52 / $5,888.44
| Facility | | $660.69 | $1,071.52 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,818.38 / $4,677.35
| Facility | | $1,819.70 | $2,818.38 | $4,677.35 |