- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.50 / $3,427.16 / $10,281.89
| Facility | | $418.50 | $3,427.16 | $10,281.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $1,438.74
| Facility | | $395.75 | $395.75 | $1,438.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.15 / $507.70 / $873.00
| Facility | | $331.15 | $507.70 | $873.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,595.72 / $1,774.32 / $12,000.00
| Facility | | $1,595.72 | $1,774.32 | $12,000.00 |