- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,096.48 / $7,079.46
| Facility | | $1,096.48 | $1,096.48 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $5,495.41 / $18,197.01
| Facility | | $2,691.53 | $5,495.41 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $4,466.84 / $10,715.19
| Facility | | $3,162.28 | $4,466.84 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $4,265.80 / $8,511.38
| Facility | | $3,467.37 | $4,265.80 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,137.96 / $3,715.35
| Facility | | $1,348.96 | $2,137.96 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,311.31 / $8,511.38
| Facility | | $1,348.96 | $3,311.31 | $8,511.38 |