- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $2,884.03 / $7,762.47
| Facility | | $190.55 | $2,884.03 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,762.47 / $13,803.84
| Facility | | $4,073.80 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $10,964.78
| Facility | | $173.78 | $173.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $213.80 / $7,413.10
| Facility | | $34.67 | $213.80 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $169.82 / $426.58
| Facility | | $128.82 | $169.82 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.04 / $6,606.93 / $50,118.72
| Facility | | $138.04 | $6,606.93 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,754.23 / $4,897.79
| Facility | | $1,318.26 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $154.88 / $478.63
| Facility | | $100.00 | $154.88 | $478.63 |