- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,677.35 / $8,317.64
| Facility | | $2,089.30 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,365.16 / $7,943.28
| Facility | | $1,659.59 | $4,365.16 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,737.80 / $3,090.30
| Facility | | $1,348.96 | $1,737.80 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $870.96 / $4,897.79
| Facility | | $676.08 | $870.96 | $4,897.79 |
- 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 |