- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $2,691.53 / $3,715.35
| Facility | | $138.04 | $2,691.53 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,071.52 / $28,840.32
| Facility | | $309.03 | $1,071.52 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $346.74
| Facility | | $154.88 | $154.88 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $380.19 / $7,079.46
| Facility | | $125.89 | $380.19 | $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
- $316.23 / $1,071.52 / $28,840.32
| Facility | | $316.23 | $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 |