- 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
- $1,905.46 / $9,549.93 / $22,387.21
| Facility | | $1,905.46 | $9,549.93 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,258.93 / $3,019.95
| Facility | | $891.25 | $1,258.93 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,202.26 / $2,398.83
| Facility | | $977.24 | $1,202.26 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $691.83 / $10,964.78
| Facility | | $398.11 | $691.83 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $12,589.25
| Facility | | $4,466.84 | $9,120.11 | $12,589.25 |