- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $2,238.72 / $3,801.89
| Facility | | $457.09 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,630.78 / $19,498.45
| Facility | | $812.83 | $3,630.78 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $1,023.29
| Facility | | $446.68 | $446.68 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $2,691.53
| Facility | | $446.68 | $478.63 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $724.44 / $7,079.46
| Facility | | $338.84 | $724.44 | $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
- $812.83 / $3,630.78 / $19,498.45
| Facility | | $812.83 | $3,630.78 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,548.13 / $8,511.38
| Facility | | $676.08 | $3,548.13 | $8,511.38 |