- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.29 / $835.07 / $10,026.21
| Facility | | $548.29 | $835.07 | $10,026.21 |
- 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
- $515.00 / $1,624.55 / $2,709.73
| Facility | | $515.00 | $1,624.55 | $2,709.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.29 / $646.16 / $991.36
| Facility | | $548.29 | $646.16 | $991.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.00 / $1,597.00 / $11,999.00
| Facility | | $902.00 | $1,597.00 | $11,999.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,132.72 / $7,929.30 / $26,542.00
| Facility | | $3,132.72 | $7,929.30 | $26,542.00 |