- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.62 / $538.62 / $10,367.35
| Facility | | $538.62 | $538.62 | $10,367.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,666.33 / $5,277.65 / $10,098.06
| Facility | | $2,666.33 | $5,277.65 | $10,098.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,309.05 / $1,857.35 / $4,468.10
| Facility | | $1,309.05 | $1,857.35 | $4,468.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,190.04 / $1,698.06 / $3,518.19
| Facility | | $1,190.04 | $1,698.06 | $3,518.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $551.42 / $928.22 / $3,083.70
| Facility | | $551.42 | $928.22 | $3,083.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,388.00 / $3,500.00 / $6,361.00
| Facility | | $1,388.00 | $3,500.00 | $6,361.00 |