- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $537.03 / $537.03
| Facility | | $363.08 | $537.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,570.88 / $8,912.51
| Facility | | $2,137.96 | $4,570.88 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,995.26 / $4,677.35
| Facility | | $1,380.38 | $1,995.26 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,905.46 / $3,715.35
| Facility | | $1,513.56 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $758.58 / $2,238.72
| Facility | | $436.52 | $758.58 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,786.30 / $8,912.51
| Facility | | $2,398.83 | $4,786.30 | $8,912.51 |