- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $1,819.70 / $9,772.37
| Facility | | $426.58 | $1,819.70 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,737.80 / $3,019.95
| Facility | | $1,584.89 | $1,737.80 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,348.96
| Facility | | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,890.45 / $8,709.64
| Facility | | $933.25 | $3,890.45 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,890.45 / $8,709.64
| Facility | | $933.25 | $3,890.45 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $389.05 / $478.63
| Facility | | $281.84 | $389.05 | $478.63 |