- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $446.68 / $446.68
| Facility | | $223.87 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $6,760.83 / $18,620.87
| Facility | | $3,548.13 | $6,760.83 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,621.81 / $3,890.45
| Facility | | $1,122.02 | $1,621.81 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,548.82 / $3,019.95
| Facility | | $1,258.93 | $1,548.82 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $501.19 / $1,819.70
| Facility | | $229.09 | $501.19 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,786.30 / $8,912.51
| Facility | | $2,398.83 | $4,786.30 | $8,912.51 |