- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $469.36 / $511.32 / $2,057.94
| Facility | | $469.36 | $511.32 | $2,057.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.96 / $778.05 / $2,613.48
| Facility | | $370.96 | $778.05 | $2,613.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,251.80 / $1,776.12 / $4,272.71
| Facility | | $1,251.80 | $1,776.12 | $4,272.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,138.00 / $1,623.80 / $3,364.34
| Facility | | $1,138.00 | $1,623.80 | $3,364.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.50 / $801.11 / $1,380.71
| Facility | | $479.50 | $801.11 | $1,380.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |