- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.80 / $504.80 / $15,667.61
| Facility | | $504.80 | $504.80 | $15,667.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,361.21 / $5,939.08 / $11,503.06
| Facility | | $2,361.21 | $5,939.08 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,218.97 / $1,729.54 / $4,160.64
| Facility | | $1,218.97 | $1,729.54 | $4,160.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,108.15 / $1,581.22 / $3,276.10
| Facility | | $1,108.15 | $1,581.22 | $3,276.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.04 / $861.28 / $3,355.94
| Facility | | $520.04 | $861.28 | $3,355.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $5,499.00 / $9,810.00
| Facility | | $3,121.00 | $5,499.00 | $9,810.00 |