- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,511.89 / $7,585.78
| Facility | | $630.96 | $2,511.89 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,230.27 / $2,570.40
| Facility | | $660.69 | $1,230.27 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $97.72 / $104.71
| Facility | | $97.72 | $97.72 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $645.65 / $1,023.29
| Facility | | $194.98 | $645.65 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $19,498.45 / $19,498.45
| Facility | | $2,754.23 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $173.78 / $1,202.26
| Facility | | $109.65 | $173.78 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.65 / $165.96 / $288.40
| Facility | | $109.65 | $165.96 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,454.71 / $4,786.30
| Facility | | $676.08 | $2,454.71 | $4,786.30 |