- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $3,235.94 / $5,623.41
| Facility | | $338.84 | $3,235.94 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,630.78 / $33,884.42
| Facility | | $812.83 | $3,630.78 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $398.11 / $912.01
| Facility | | $398.11 | $398.11 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $707.95 / $7,079.46
| Facility | | $309.03 | $707.95 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $4,677.35 / $4,677.35
| Facility | | $4,677.35 | $4,677.35 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,630.78 / $33,884.42
| Facility | | $812.83 | $3,630.78 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |