- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.02 / $466.02 / $466.02
| Facility | | $466.02 | $466.02 | $466.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,142.55 / $8,365.08 / $17,252.16
| Facility | | $4,142.55 | $8,365.08 | $17,252.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,029.25 / $1,459.60 / $3,511.26
| Facility | | $1,029.25 | $1,459.60 | $3,511.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $836.70 / $1,334.42 / $2,764.78
| Facility | | $836.70 | $1,334.42 | $2,764.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.39 / $853.92 / $3,500.00
| Facility | | $732.39 | $853.92 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |