- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $912.01 / $3,890.45
| Facility | | $363.08 | $912.01 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,398.83 / $4,365.16
| Facility | | $1,513.56 | $2,398.83 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $426.58 / $562.34
| Facility | | $309.03 | $426.58 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $588.84 / $588.84
| Facility | | $34.67 | $588.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $954.99 / $3,388.44
| Facility | | $389.05 | $954.99 | $3,388.44 |