- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,041.74 / $9,772.37
| Facility | | $1,819.70 | $2,041.74 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $4,677.35 / $6,309.57
| Facility | | $3,467.37 | $4,677.35 | $6,309.57 |
- 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
- $851.14 / $4,466.84 / $10,000.00
| Facility | | $851.14 | $4,466.84 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $4,466.84 / $10,000.00
| Facility | | $851.14 | $4,466.84 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $512.86 / $741.31
| Facility | | $446.68 | $512.86 | $741.31 |