- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.19 / $5,611.88 / $9,322.79
| Facility | | $596.19 | $5,611.88 | $9,322.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,326.31 / $1,326.31 / $1,345.66
| Facility | | $1,326.31 | $1,326.31 | $1,345.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $1,438.74
| Facility | | $606.10 | $606.10 | $1,438.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.19 / $752.17 / $1,346.00
| Facility | | $596.19 | $752.17 | $1,346.00 |
- 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
- $2,219.19 / $4,754.80 / $26,542.00
| Facility | | $2,219.19 | $4,754.80 | $26,542.00 |