- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $5,011.87
| Facility | | $575.44 | $575.44 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $11,481.54 / $26,915.35
| Facility | | $1,412.54 | $11,481.54 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,187.76 / $5,248.07
| Facility | | $1,380.38 | $2,187.76 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,089.30 / $4,168.69
| Facility | | $1,698.24 | $2,089.30 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $870.96 / $1,819.70
| Facility | | $524.81 | $870.96 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,786.30 / $9,332.54
| Facility | | $1,659.59 | $4,786.30 | $9,332.54 |