- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.51 / $3,908.01 / $13,841.56
| Facility | | $110.51 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.62 / $491.41 / $950.54
| Facility | | $373.62 | $491.41 | $950.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.58 / $317.58 / $317.58
| Facility | | $317.58 | $317.58 | $317.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.46 / $174.12 / $496.74
| Facility | | $99.46 | $174.12 | $496.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.09 / $276.68 / $402.27
| Facility | | $212.09 | $276.68 | $402.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.74 / $678.07 / $4,317.00
| Facility | | $496.74 | $678.07 | $4,317.00 |