- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $2,884.03 / $7,413.10
| Facility | | $691.83 | $2,884.03 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,023.29 / $2,089.30
| Facility | | $575.44 | $1,023.29 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $457.09
| Facility | | $245.47 | $245.47 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $28,840.32 / $28,840.32
| Facility | | $2,137.96 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $512.86 / $3,715.35
| Facility | | $257.04 | $512.86 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $407.38 / $676.08
| Facility | | $245.47 | $407.38 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,698.24 / $4,168.69
| Facility | | $436.52 | $1,698.24 | $4,168.69 |