- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $199.53 / $2,630.27
| Facility | | $199.53 | $199.53 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $7,079.46 / $16,982.44
| Facility | | $1,202.26 | $7,079.46 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $707.95 / $1,659.59
| Facility | | $501.19 | $707.95 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $676.08 / $1,318.26
| Facility | | $537.03 | $676.08 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $416.87 / $9,332.54
| Facility | | $208.93 | $416.87 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $6,760.83 / $10,715.19
| Facility | | $1,584.89 | $6,760.83 | $10,715.19 |