- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $7,079.46
| Facility | | $208.93 | $208.93 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,801.89 / $8,709.64
| Facility | | $1,380.38 | $3,801.89 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $812.83 / $1,905.46
| Facility | | $501.19 | $812.83 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $776.25 / $1,513.56
| Facility | | $616.60 | $776.25 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $371.54 / $2,511.89
| Facility | | $218.78 | $371.54 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $3,467.37 / $6,760.83
| Facility | | $1,230.27 | $3,467.37 | $6,760.83 |