- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.52 / $2,108.84 / $6,010.67
| Facility | | $165.52 | $2,108.84 | $6,010.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.15 / $1,627.07 / $2,761.08
| Facility | | $1,479.15 | $1,627.07 | $2,761.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.44 / $650.35 / $1,226.89
| Facility | | $323.44 | $650.35 | $1,226.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.12 / $203.66 / $645.00
| Facility | | $160.12 | $203.66 | $645.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.70 / $3,590.15 / $12,000.00
| Facility | | $953.70 | $3,590.15 | $12,000.00 |