- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.43 / $494.43 / $4,775.13
| Facility | | $494.43 | $494.43 | $4,775.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,226.86 / $5,489.43 / $11,441.84
| Facility | | $2,226.86 | $5,489.43 | $11,441.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.07 / $1,801.21 / $4,333.05
| Facility | | $1,154.07 | $1,801.21 | $4,333.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.11 / $1,643.72 / $3,411.85
| Facility | | $1,000.11 | $1,643.72 | $3,411.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $494.43 / $884.29 / $1,589.57
| Facility | | $494.43 | $884.29 | $1,589.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,623.00 / $4,746.00 / $8,812.00
| Facility | | $1,623.00 | $4,746.00 | $8,812.00 |