- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $6,918.31
| Facility | | $223.87 | $223.87 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $6,309.57 / $14,791.08
| Facility | | $2,818.38 | $6,309.57 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $870.96 / $2,041.74
| Facility | | $537.03 | $870.96 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $977.24 / $1,621.81
| Facility | | $660.69 | $977.24 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $389.05 / $3,090.30
| Facility | | $223.87 | $389.05 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,786.30 / $8,912.51
| Facility | | $1,659.59 | $4,786.30 | $8,912.51 |