- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $6,760.83
| Facility | | $295.12 | $295.12 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $9,772.37 / $23,442.29
| Facility | | $3,981.07 | $9,772.37 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,122.02 / $2,691.53
| Facility | | $794.33 | $1,122.02 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,096.48 / $2,137.96
| Facility | | $870.96 | $1,096.48 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $630.96 / $8,317.64
| Facility | | $389.05 | $630.96 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $13,489.63
| Facility | | $2,884.03 | $5,248.07 | $13,489.63 |