- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $2,691.53 / $5,011.87
| Facility | | $691.83 | $2,691.53 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $501.19 / $2,754.23
| Facility | | $56.23 | $501.19 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $676.08 / $1,905.46
| Facility | | $676.08 | $676.08 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $218.78 / $7,079.46
| Facility | | $102.33 | $218.78 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,819.70 / $3,467.37
| Facility | | $229.09 | $1,819.70 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $5,248.07 / $5,248.07
| Facility | | $5,248.07 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $501.19 / $2,754.23
| Facility | | $56.23 | $501.19 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,819.70 / $2,818.38
| Facility | | $309.03 | $1,819.70 | $2,818.38 |