- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $177.83 / $2,630.27
| Facility | | $177.83 | $177.83 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $5,754.40 / $15,135.61
| Facility | | $3,235.94 | $5,754.40 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $724.44 / $1,698.24
| Facility | | $512.86 | $724.44 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $691.83 / $1,348.96
| Facility | | $549.54 | $691.83 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $398.11 / $6,760.83
| Facility | | $234.42 | $398.11 | $6,760.83 |
- 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 |