- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,388.44 / $5,623.41
| Facility | | $1,380.38 | $3,388.44 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,890.45 / $13,803.84
| Facility | | $56.23 | $3,890.45 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $741.31
| Facility | | $50.12 | $676.08 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $2,041.74 / $8,511.38
| Facility | | $302.00 | $2,041.74 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $5,011.87 / $13,182.57
| Facility | | $776.25 | $5,011.87 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,890.45 / $13,803.84
| Facility | | $56.23 | $3,890.45 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $5,370.32 / $13,182.57
| Facility | | $1,584.89 | $5,370.32 | $13,182.57 |