- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,715.35 / $12,882.50
| Facility | | $977.24 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $977.24 / $4,365.16
| Facility | | $575.44 | $977.24 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $512.86
| Facility | | $512.86 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $7,079.46
| Facility | | $54.95 | $56.23 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $954.99 / $5,248.07
| Facility | | $512.86 | $954.99 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $630.96 / $1,230.27
| Facility | | $501.19 | $630.96 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,511.89 / $10,232.93
| Facility | | $436.52 | $2,511.89 | $10,232.93 |