- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $5,011.87
| Facility | | $457.09 | $457.09 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $5,128.61 / $12,589.25
| Facility | | $1,862.09 | $5,128.61 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,698.24 / $3,981.07
| Facility | | $1,174.90 | $1,698.24 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,621.81 / $3,162.28
| Facility | | $1,288.25 | $1,621.81 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $891.25 / $9,332.54
| Facility | | $467.74 | $891.25 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $6,309.57 / $12,882.50
| Facility | | $3,090.30 | $6,309.57 | $12,882.50 |