- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $2,818.38 / $5,128.61
| Facility | | $173.78 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $1,071.52 / $28,840.32
| Facility | | $331.13 | $1,071.52 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $371.54
| Facility | | $162.18 | $162.18 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $501.19 / $7,079.46
| Facility | | $134.90 | $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
- $338.84 / $1,071.52 / $28,840.32
| Facility | | $338.84 | $1,071.52 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,819.70 / $2,818.38
| Facility | | $501.19 | $1,819.70 | $2,818.38 |