- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $316.23 / $5,011.87
| Facility | | $316.23 | $316.23 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $6,606.93 / $15,848.93
| Facility | | $2,238.72 | $6,606.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,202.26 / $2,818.38
| Facility | | $831.76 | $1,202.26 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,148.15 / $2,238.72
| Facility | | $912.01 | $1,148.15 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $660.69 / $8,317.64
| Facility | | $407.38 | $660.69 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,248.07 / $9,120.11
| Facility | | $3,235.94 | $5,248.07 | $9,120.11 |