- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $2,630.27
| Facility | | $251.19 | $251.19 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $7,079.46 / $16,982.44
| Facility | | $1,479.11 | $7,079.46 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $870.96 / $2,089.30
| Facility | | $616.60 | $870.96 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $831.76 / $1,659.59
| Facility | | $676.08 | $831.76 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $524.81 / $9,332.54
| Facility | | $323.59 | $524.81 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $6,025.60 / $10,715.19
| Facility | | $3,019.95 | $6,025.60 | $10,715.19 |