- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $2,238.72 / $3,801.89
| Facility | | $346.74 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $5,011.87 / $19,498.45
| Facility | | $812.83 | $5,011.87 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $891.25
| Facility | | $389.05 | $389.05 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $660.69 / $7,079.46
| Facility | | $302.00 | $660.69 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $5,011.87 / $19,498.45
| Facility | | $812.83 | $5,011.87 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |