- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $2,630.27
| Facility | | $162.18 | $162.18 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,413.10 / $22,908.68
| Facility | | $4,265.80 | $7,413.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $645.65 / $1,548.82
| Facility | | $457.09 | $645.65 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $616.60 / $1,202.26
| Facility | | $489.78 | $616.60 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $354.81 / $7,762.47
| Facility | | $199.53 | $354.81 | $7,762.47 |
- 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 |