- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $2,630.27
| Facility | | $223.87 | $223.87 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $1,445.44 / $3,467.37
| Facility | | $1.00 | $1,445.44 | $3,467.37 |
- 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 / $794.33 / $1,513.56
| Facility | | $630.96 | $794.33 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $389.05 / $1,445.44
| Facility | | $245.47 | $389.05 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,570.40 / $3,715.35
| Facility | | $602.56 | $2,570.40 | $3,715.35 |