- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,090.30 / $6,760.83
| Facility | | $1,584.89 | $3,090.30 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,479.11 / $2,691.53
| Facility | | $549.54 | $1,479.11 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,905.46 / $3,090.30
| Facility | | $1,445.44 | $1,905.46 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,071.52 / $5,623.41
| Facility | | $794.33 | $1,071.52 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $3,890.45 / $7,244.36
| Facility | | $2,818.38 | $3,890.45 | $7,244.36 |