- 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
- $288.40 / $489.78 / $2,630.27
| Facility | | $288.40 | $489.78 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $239.88 / $251.19
| Facility | | $79.43 | $239.88 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $1,659.59
| Facility | | $54.95 | $56.23 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $346.74 / $4,073.80
| Facility | | $239.88 | $346.74 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $302.00 / $467.74
| Facility | | $234.42 | $302.00 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,128.61 / $10,964.78
| Facility | | $1,698.24 | $5,128.61 | $10,964.78 |