- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,818.38 / $10,471.29
| Facility | | $1,348.96 | $2,818.38 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,466.84 / $12,022.64
| Facility | | $2,630.27 | $4,466.84 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,659.59 / $2,137.96
| Facility | | $1,348.96 | $1,659.59 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,511.89 / $2,511.89
| Facility | | $2,290.87 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,890.45 / $8,511.38
| Facility | | $741.31 | $3,890.45 | $8,511.38 |