- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $2,187.76 / $3,801.89
| Facility | | $524.81 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,398.83 / $19,498.45
| Facility | | $616.60 | $2,398.83 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $478.63 / $1,096.48
| Facility | | $478.63 | $478.63 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $1,479.11
| Facility | | $446.68 | $478.63 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $831.76 / $7,079.46
| Facility | | $380.19 | $831.76 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,398.83 / $19,498.45
| Facility | | $616.60 | $2,398.83 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,162.28 / $8,511.38
| Facility | | $676.08 | $3,162.28 | $8,511.38 |