- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,818.38 / $7,585.78
| Facility | | $676.08 | $2,818.38 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $524.81 / $1,096.48
| Facility | | $275.42 | $524.81 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $223.87 / $234.42
| Facility | | $107.15 | $223.87 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $28,840.32 / $28,840.32
| Facility | | $6,456.54 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $269.15 / $3,715.35
| Facility | | $112.20 | $269.15 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $213.80 / $380.19
| Facility | | $107.15 | $213.80 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $1,047.13 / $2,691.53
| Facility | | $162.18 | $1,047.13 | $2,691.53 |