- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,270.38 / $1,748.25 / $2,628.37
| Facility | | $1,270.38 | $1,748.25 | $2,628.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,080.86 / $2,820.19 / $3,645.59
| Facility | | $2,080.86 | $2,820.19 | $3,645.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,782.82 / $2,534.55 / $3,249.42
| Facility | | $1,782.82 | $2,534.55 | $3,249.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.45 / $1,950.91 / $3,145.85
| Facility | | $1,000.45 | $1,950.91 | $3,145.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,270.38 / $1,880.12 / $2,881.12
| Facility | | $1,270.38 | $1,880.12 | $2,881.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.00 / $1,292.71 / $3,007.59
| Facility | | $750.00 | $1,292.71 | $3,007.59 |