- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $3,890.45 / $9,120.11
| Facility | | $954.99 | $3,890.45 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,548.82 / $2,454.71
| Facility | | $1,148.15 | $1,548.82 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $758.58 / $5,623.41
| Facility | | $457.09 | $758.58 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,089.30 / $4,677.35
| Facility | | $1,445.44 | $2,089.30 | $4,677.35 |