- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,981.07 / $5,623.41
| Facility | | $2,630.27 | $3,981.07 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,388.44 / $4,570.88
| Facility | | $2,344.23 | $3,388.44 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,698.24 / $2,884.03
| Facility | | $630.96 | $1,698.24 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,897.79 / $7,943.28
| Facility | | $2,089.30 | $4,897.79 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,951.21 / $5,248.07
| Facility | | $1,348.96 | $2,951.21 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $3,019.95 / $5,128.61
| Facility | | $1,148.15 | $3,019.95 | $5,128.61 |