- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $363.08 / $5,011.87
| Facility | | $363.08 | $363.08 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $6,606.93 / $15,848.93
| Facility | | $933.25 | $6,606.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,380.38 / $3,311.31
| Facility | | $977.24 | $1,380.38 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,348.96 / $2,630.27
| Facility | | $1,071.52 | $1,348.96 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $794.33 / $8,317.64
| Facility | | $524.81 | $794.33 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,248.07 / $9,120.11
| Facility | | $2,884.03 | $5,248.07 | $9,120.11 |