- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.45 / $3,095.38 / $8,411.36
| Facility | | $333.45 | $3,095.38 | $8,411.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.76 / $4,376.30 / $9,046.11
| Facility | | $2,088.76 | $4,376.30 | $9,046.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.42 / $1,159.80 / $2,790.05
| Facility | | $817.42 | $1,159.80 | $2,790.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $743.11 / $1,060.33 / $2,196.89
| Facility | | $743.11 | $1,060.33 | $2,196.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.37 / $646.11 / $4,947.76
| Facility | | $350.37 | $646.11 | $4,947.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |