- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.39 / $348.39 / $12,113.57
| Facility | | $348.39 | $348.39 | $12,113.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $827.16 / $827.16 / $10,333.54
| Facility | | $827.16 | $827.16 | $10,333.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $731.80 / $1,074.25 / $3,048.65
| Facility | | $731.80 | $1,074.25 | $3,048.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.14 / $1,005.93 / $2,400.51
| Facility | | $632.14 | $1,005.93 | $2,400.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.84 / $568.69 / $1,088.29
| Facility | | $354.84 | $568.69 | $1,088.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,960.00 / $5,331.00 / $7,872.00
| Facility | | $2,960.00 | $5,331.00 | $7,872.00 |