- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.91 / $404.11 / $5,055.71
| Facility | | $157.91 | $404.11 | $5,055.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.71 / $2,053.08 / $4,193.72
| Facility | | $804.71 | $2,053.08 | $4,193.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $939.02 / $1,465.57 / $3,525.63
| Facility | | $939.02 | $1,465.57 | $3,525.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $813.75 / $1,206.14 / $2,776.09
| Facility | | $813.75 | $1,206.14 | $2,776.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.36 / $493.31 / $1,189.79
| Facility | | $227.36 | $493.31 | $1,189.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,500.00 / $6,361.00
| Facility | | $1,224.00 | $3,500.00 | $6,361.00 |