- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,737.80 / $5,495.41
| Facility | | $851.14 | $1,737.80 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.11 / $1,621.81 / $5,011.87
| Facility | | $85.11 | $1,621.81 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $3,388.44 / $3,388.44
| Facility | | $3,388.44 | $3,388.44 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,737.80 / $5,495.41
| Facility | | $851.14 | $1,737.80 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $933.25 / $1,479.11
| Facility | | $758.58 | $933.25 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $977.24 / $1,479.11
| Facility | | $794.33 | $977.24 | $1,479.11 |