- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $642.70 / $2,663.12 / $3,986.52
| Facility | | $642.70 | $2,663.12 | $3,986.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.84 / $3,110.00 / $7,642.94
| Facility | | $441.84 | $3,110.00 | $7,642.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.52 / $297.08 / $582.73
| Facility | | $228.52 | $297.08 | $582.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $200.50 / $416.68 / $7,218.72
| Facility | | $200.50 | $416.68 | $7,218.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.87 / $3,293.87 / $3,298.15
| Facility | | $3,293.87 | $3,293.87 | $3,298.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,287.00 / $9,401.00
| Facility | | $55.00 | $4,287.00 | $9,401.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $4,983.00 / $8,810.00
| Facility | | $2,155.00 | $4,983.00 | $8,810.00 |