- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276.12 / $276.12 / $3,655.75
| Facility | | $276.12 | $276.12 | $3,655.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.76 / $5,064.68 / $11,441.84
| Facility | | $1,474.76 | $5,064.68 | $11,441.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.18 / $960.33 / $2,310.19
| Facility | | $677.18 | $960.33 | $2,310.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.50 / $877.97 / $1,819.05
| Facility | | $550.50 | $877.97 | $1,819.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $403.48 / $523.16 / $3,378.00
| Facility | | $403.48 | $523.16 | $3,378.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |