- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,951.21 / $7,585.78
| Facility | | $707.95 | $2,951.21 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,677.35 / $9,120.11
| Facility | | $2,137.96 | $4,677.35 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $154.88 / $165.96
| Facility | | $154.88 | $154.88 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $2,511.89 / $3,162.28
| Facility | | $316.23 | $2,511.89 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $10,715.19
| Facility | | $54.95 | $56.23 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $346.74 / $4,265.80
| Facility | | $181.97 | $346.74 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $223.87 / $426.58
| Facility | | $165.96 | $223.87 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,897.79
| Facility | | $724.44 | $2,511.89 | $4,897.79 |