- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $346.74 / $346.74
| Facility | | $186.21 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $4,786.30 / $9,332.54
| Facility | | $2,951.21 | $4,786.30 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,318.26 / $3,162.28
| Facility | | $933.25 | $1,318.26 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,258.93 / $2,454.71
| Facility | | $1,023.29 | $1,258.93 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $478.63 / $5,248.07
| Facility | | $275.42 | $478.63 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $8,912.51
| Facility | | $2,884.03 | $5,248.07 | $8,912.51 |