- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $5,888.44 / $10,471.29
| Facility | | $1,949.84 | $5,888.44 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $4,168.69 / $4,365.16
| Facility | | $1,445.44 | $4,168.69 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,187.76 / $9,549.93
| Facility | | $1,288.25 | $2,187.76 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $831.76 / $6,309.57
| Facility | | $575.44 | $831.76 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,818.38 / $6,309.57
| Facility | | $1,778.28 | $2,818.38 | $6,309.57 |