- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,754.23 / $7,413.10
| Facility | | $575.44 | $2,754.23 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $181.97 / $426.58
| Facility | | $104.71 | $181.97 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $323.59
| Facility | | $162.18 | $162.18 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $1,202.26 / $2,187.76
| Facility | | $257.04 | $1,202.26 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $28,840.32 / $28,840.32
| Facility | | $1,995.26 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $288.40 / $707.95
| Facility | | $158.49 | $288.40 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $263.03 / $501.19
| Facility | | $154.88 | $263.03 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $1,047.13 / $2,691.53
| Facility | | $151.36 | $1,047.13 | $2,691.53 |