- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,818.38 / $5,128.61
| Facility | | $645.65 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,265.80 / $11,220.18
| Facility | | $56.23 | $4,265.80 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $537.03
| Facility | | $229.09 | $229.09 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $1,122.02 / $7,585.78
| Facility | | $186.21 | $1,122.02 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $3,311.31 / $3,311.31
| Facility | | $3,311.31 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,570.88 / $11,220.18
| Facility | | $56.23 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $11,220.18
| Facility | | $2,041.74 | $5,248.07 | $11,220.18 |