- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $446.68 / $3,162.28
| Facility | | $263.03 | $446.68 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,412.54 / $3,235.94
| Facility | | $660.69 | $1,412.54 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,659.59 / $3,981.07
| Facility | | $1,174.90 | $1,659.59 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,584.89 / $3,090.30
| Facility | | $1,258.93 | $1,584.89 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $602.56 / $1,819.70
| Facility | | $309.03 | $602.56 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,238.72 / $4,265.80
| Facility | | $1,000.00 | $2,238.72 | $4,265.80 |