- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.89 / $3,667.06 / $8,391.67
| Facility | | $302.89 | $3,667.06 | $8,391.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.74 / $1,432.77 / $2,702.90
| Facility | | $263.74 | $1,432.77 | $2,702.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.51 / $293.64 / $419.44
| Facility | | $224.51 | $293.64 | $419.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.68 / $7,909.30 / $26,542.00
| Facility | | $1,300.68 | $7,909.30 | $26,542.00 |