- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $354.81 / $354.81
| Facility | | $95.50 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,630.78 / $8,709.64
| Facility | | $1,258.93 | $3,630.78 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,348.96 / $3,235.94
| Facility | | $831.76 | $1,348.96 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,288.25 / $2,511.89
| Facility | | $1,047.13 | $1,288.25 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $338.84 / $1,023.29
| Facility | | $114.82 | $338.84 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,467.37 / $6,456.54
| Facility | | $1,445.44 | $3,467.37 | $6,456.54 |