- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.19 / $459.19 / $5,341.38
| Facility | | $459.19 | $459.19 | $5,341.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.76 / $4,376.30 / $9,046.11
| Facility | | $2,088.76 | $4,376.30 | $9,046.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,121.32 / $1,590.99 / $3,827.34
| Facility | | $1,121.32 | $1,590.99 | $3,827.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.38 / $1,454.54 / $3,013.65
| Facility | | $1,019.38 | $1,454.54 | $3,013.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $787.88 / $2,415.82
| Facility | | $450.00 | $787.88 | $2,415.82 |
- 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 |