- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,312.09 / $1,844.95 / $3,750.25
| Facility | | $1,312.09 | $1,844.95 | $3,750.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.50 / $1,790.52 / $2,449.42
| Facility | | $604.50 | $1,790.52 | $2,449.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,432.07 / $1,795.13 / $2,052.30
| Facility | | $1,432.07 | $1,795.13 | $2,052.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,132.86 / $1,873.52 / $2,587.41
| Facility | | $1,132.86 | $1,873.52 | $2,587.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $617.92 / $1,927.69 / $2,794.18
| Facility | | $617.92 | $1,927.69 | $2,794.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.00 / $1,539.26 / $2,584.21
| Facility | | $250.00 | $1,539.26 | $2,584.21 |