- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $2,630.27
| Facility | | $457.09 | $457.09 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $6,456.54 / $12,589.25
| Facility | | $2,884.03 | $6,456.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,778.28 / $4,265.80
| Facility | | $1,096.48 | $1,778.28 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,698.24 / $3,311.31
| Facility | | $1,380.38 | $1,698.24 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $758.58 / $1,778.28
| Facility | | $467.74 | $758.58 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,715.35 / $7,079.46
| Facility | | $1,995.26 | $3,715.35 | $7,079.46 |