- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,890.45 / $8,317.64
| Facility | | $724.44 | $3,890.45 | $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
- $263.03 / $1,230.27 / $2,454.71
| Facility | | $263.03 | $1,230.27 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $309.03
| Facility | | $309.03 | $309.03 | $309.03 |
- 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
- $269.15 / $316.23 / $331.13
| Facility | | $269.15 | $316.23 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $190.55 / $1,071.52
| Facility | | $100.00 | $190.55 | $1,071.52 |
- 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 |