- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $2,754.23 / $4,897.79
| Facility | | $151.36 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $1,071.52 / $28,840.32
| Facility | | $275.42 | $1,071.52 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $128.82 / $302.00
| Facility | | $128.82 | $128.82 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $501.19 / $7,079.46
| Facility | | $109.65 | $501.19 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $1,071.52 / $28,840.32
| Facility | | $275.42 | $1,071.52 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,819.70 / $2,818.38
| Facility | | $575.44 | $1,819.70 | $2,818.38 |