- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $645.65 / $2,398.83
| Facility | | $234.42 | $645.65 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $281.84 / $281.84
| Facility | | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $8,317.64
| Facility | | $616.60 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $281.84 / $302.00
| Facility | | $263.03 | $281.84 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $309.03 / $407.38
| Facility | | $75.86 | $309.03 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $2,398.83 / $6,025.60
| Facility | | $549.54 | $2,398.83 | $6,025.60 |