- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,365.16 / $9,120.11
| Facility | | $1,659.59 | $4,365.16 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,244.36 / $12,022.64
| Facility | | $3,090.30 | $7,244.36 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,754.40 / $8,709.64
| Facility | | $3,235.94 | $5,754.40 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $5,370.32 / $13,182.57
| Facility | | $2,570.40 | $5,370.32 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $4,786.30 / $8,709.64
| Facility | | $2,290.87 | $4,786.30 | $8,709.64 |