- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,818.38 / $6,918.31
| Facility | | $616.60 | $2,818.38 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $512.86 / $1,096.48
| Facility | | $269.15 | $512.86 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $338.84 / $338.84
| Facility | | $120.23 | $338.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $28,840.32 / $28,840.32
| Facility | | $1,995.26 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $223.87 / $3,715.35
| Facility | | $125.89 | $223.87 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $181.97 / $288.40
| Facility | | $120.23 | $181.97 | $288.40 |
- 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 |