- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,623.41 / $12,302.69
| Facility | | $1,778.28 | $5,623.41 | $12,302.69 |
- 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
- $2,187.76 / $2,398.83 / $9,549.93
| Facility | | $2,187.76 | $2,398.83 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,023.29 / $6,309.57
| Facility | | $741.31 | $1,023.29 | $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 |