- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.73 / $3,908.01 / $13,841.56
| Facility | | $595.73 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,507.81 / $1,983.18 / $3,836.12
| Facility | | $1,507.81 | $1,983.18 | $3,836.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.91 / $716.91 / $716.91
| Facility | | $716.91 | $716.91 | $716.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $355.08 / $685.09 / $1,747.97
| Facility | | $355.08 | $685.09 | $1,747.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.79 / $970.95 / $1,625.79
| Facility | | $711.79 | $970.95 | $1,625.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,108.26 / $1,512.82 / $6,043.00
| Facility | | $1,108.26 | $1,512.82 | $6,043.00 |