- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $169.82 / $2,630.27
| Facility | | $169.82 | $169.82 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $11,481.54 / $26,915.35
| Facility | | $1,148.15 | $11,481.54 | $26,915.35 |
- 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 / $630.96 / $1,230.27
| Facility | | $512.86 | $630.96 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $309.03 / $3,311.31
| Facility | | $181.97 | $309.03 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $5,495.41 / $10,715.19
| Facility | | $1,445.44 | $5,495.41 | $10,715.19 |