- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $204.17 / $2,630.27
| Facility | | $204.17 | $204.17 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $3,311.31 / $7,943.28
| Facility | | $467.74 | $3,311.31 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $707.95 / $1,698.24
| Facility | | $501.19 | $707.95 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $676.08 / $1,318.26
| Facility | | $549.54 | $676.08 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $398.11 / $4,677.35
| Facility | | $263.03 | $398.11 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $4,265.80 / $6,456.54
| Facility | | $2,691.53 | $4,265.80 | $6,456.54 |