- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $3,388.44 / $5,623.41
| Facility | | $229.09 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,715.35 / $10,232.93
| Facility | | $562.34 | $3,715.35 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $676.08 / $741.31
| Facility | | $676.08 | $676.08 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $575.44 / $7,079.46
| Facility | | $218.78 | $575.44 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $5,011.87 / $13,182.57
| Facility | | $776.25 | $5,011.87 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,715.35 / $10,232.93
| Facility | | $562.34 | $3,715.35 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,981.07 / $12,882.50
| Facility | | $1,584.89 | $3,981.07 | $12,882.50 |