- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $1,819.70 / $8,912.51
| Facility | | $204.17 | $1,819.70 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,412.54 / $2,630.27
| Facility | | $1,288.25 | $1,412.54 | $2,630.27 |
- 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
- $691.83 / $3,630.78 / $7,943.28
| Facility | | $691.83 | $3,630.78 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $3,630.78 / $7,943.28
| Facility | | $691.83 | $3,630.78 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $331.13 / $389.05
| Facility | | $234.42 | $331.13 | $389.05 |