- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $2,630.27
| Facility | | $173.78 | $173.78 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $7,244.36 / $17,378.01
| Facility | | $1,096.48 | $7,244.36 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $660.69 / $1,584.89
| Facility | | $416.87 | $660.69 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $645.65 / $1,258.93
| Facility | | $512.86 | $645.65 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $302.00 / $2,290.87
| Facility | | $177.83 | $302.00 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $3,467.37 / $7,079.46
| Facility | | $1,230.27 | $3,467.37 | $7,079.46 |