- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,715.35 / $10,715.19
| Facility | | $660.69 | $3,715.35 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,511.89 / $7,943.28
| Facility | | $954.99 | $2,511.89 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $457.09 / $1,737.80
| Facility | | $407.38 | $457.09 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $741.31 / $2,137.96
| Facility | | $512.86 | $741.31 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $741.31 / $2,818.38
| Facility | | $512.86 | $741.31 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $4,073.80
| Facility | | $100.00 | $100.00 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $4,168.69 / $7,413.10
| Facility | | $794.33 | $4,168.69 | $7,413.10 |