- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $5,011.87
| Facility | | $213.80 | $213.80 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $7,244.36 / $17,378.01
| Facility | | $1,412.54 | $7,244.36 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $831.76 / $1,949.84
| Facility | | $512.86 | $831.76 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $794.33 / $1,548.82
| Facility | | $630.96 | $794.33 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $416.87 / $1,621.81
| Facility | | $234.42 | $416.87 | $1,621.81 |
- 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 |