- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $223.87
| Facility | | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $14,791.08 / $34,673.69
| Facility | | $1,548.82 | $14,791.08 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $812.83 / $1,949.84
| Facility | | $575.44 | $812.83 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $776.25 / $1,513.56
| Facility | | $630.96 | $776.25 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $457.09 / $3,311.31
| Facility | | $245.47 | $457.09 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,467.37 / $6,456.54
| Facility | | $1,348.96 | $3,467.37 | $6,456.54 |