- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,949.84 / $7,943.28
| Facility | | $549.54 | $1,949.84 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,454.71 / $4,365.16
| Facility | | $1,513.56 | $2,454.71 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $398.11 / $549.54
| Facility | | $323.59 | $398.11 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $630.96 / $630.96
| Facility | | $34.67 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,348.96 / $5,248.07
| Facility | | $524.81 | $1,348.96 | $5,248.07 |