- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.47 / $7,838.38 / $7,838.38
| Facility | | $567.47 | $7,838.38 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,339.06 / $8,392.32 / $13,362.65
| Facility | | $3,339.06 | $8,392.32 | $13,362.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.55 / $604.55 / $1,656.16
| Facility | | $604.55 | $604.55 | $1,656.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.64 / $588.80 / $776.08
| Facility | | $456.64 | $588.80 | $776.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $6,599.00 / $11,994.45
| Facility | | $936.00 | $6,599.00 | $11,994.45 |