- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,691.53 / $8,317.64
| Facility | | $707.95 | $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
- $346.74 / $794.33 / $1,698.24
| Facility | | $346.74 | $794.33 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $457.09 / $457.09
| Facility | | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,290.87 / $7,762.47
| Facility | | $707.95 | $2,290.87 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $512.86 / $1,412.54
| Facility | | $436.52 | $512.86 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $309.03 / $616.60
| Facility | | $223.87 | $309.03 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,905.46 / $4,265.80
| Facility | | $549.54 | $1,905.46 | $4,265.80 |