- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.75 / $654.75 / $7,403.35
| Facility | | $654.75 | $654.75 | $7,403.35 |
- 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
- $1,580.96 / $2,243.15 / $5,396.20
| Facility | | $1,580.96 | $2,243.15 | $5,396.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,437.23 / $2,050.78 / $4,248.97
| Facility | | $1,437.23 | $2,050.78 | $4,248.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.99 / $1,106.53 / $3,307.00
| Facility | | $602.99 | $1,106.53 | $3,307.00 |
- 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 |