- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,818.38 / $4,073.80
| Facility | | $1,513.56 | $2,818.38 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $4,897.79
| Facility | | $56.23 | $1,258.93 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $1,659.59
| Facility | | $676.08 | $741.31 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $323.59 / $7,079.46
| Facility | | $177.83 | $323.59 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $1,698.24 / $1,698.24
| Facility | | $1,698.24 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $4,897.79
| Facility | | $56.23 | $1,258.93 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,467.37 / $8,511.38
| Facility | | $676.08 | $3,467.37 | $8,511.38 |