- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $2,238.72 / $3,801.89
| Facility | | $165.96 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $1,318.26 / $19,498.45
| Facility | | $269.15 | $1,318.26 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $128.82 / $302.00
| Facility | | $128.82 | $128.82 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $380.19 / $7,079.46
| Facility | | $104.71 | $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
- $269.15 / $1,318.26 / $19,498.45
| Facility | | $269.15 | $1,318.26 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,819.70 / $2,818.38
| Facility | | $549.54 | $1,819.70 | $2,818.38 |