- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $5,011.87
| Facility | | $512.86 | $512.86 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,890.45 / $11,220.18
| Facility | | $2,290.87 | $3,890.45 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,905.46 / $4,466.84
| Facility | | $1,348.96 | $1,905.46 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,819.70 / $3,548.13
| Facility | | $1,445.44 | $1,819.70 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $870.96 / $1,548.82
| Facility | | $512.86 | $870.96 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,818.38 / $4,265.80
| Facility | | $602.56 | $2,818.38 | $4,265.80 |