- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $426.58 / $2,238.72
| Facility | | $426.58 | $426.58 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,585.78 / $22,908.68
| Facility | | $4,365.16 | $7,585.78 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,548.82 / $3,715.35
| Facility | | $1,096.48 | $1,548.82 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,479.11 / $2,884.03
| Facility | | $1,202.26 | $1,479.11 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $794.33 / $3,981.07
| Facility | | $426.58 | $794.33 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,467.37 / $7,079.46
| Facility | | $1,380.38 | $3,467.37 | $7,079.46 |