- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $223.87 / $4,897.79
| Facility | | $89.13 | $223.87 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,168.69 / $9,332.54
| Facility | | $2,398.83 | $4,168.69 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $794.33 / $1,905.46
| Facility | | $549.54 | $794.33 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $758.58 / $1,513.56
| Facility | | $616.60 | $758.58 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $239.88 / $2,290.87
| Facility | | $100.00 | $239.88 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,467.37 / $6,456.54
| Facility | | $1,380.38 | $3,467.37 | $6,456.54 |