- 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
- $933.25 / $1,621.81 / $3,388.44
| Facility | | $933.25 | $1,621.81 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $707.95 / $707.95
| Facility | | $147.91 | $707.95 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $831.76 / $1,071.52
| Facility | | $288.40 | $831.76 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $19,498.45 / $19,498.45
| Facility | | $3,630.78 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $269.15 / $1,202.26
| Facility | | $162.18 | $269.15 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $257.04 / $457.09
| Facility | | $162.18 | $257.04 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,511.89 / $4,786.30
| Facility | | $676.08 | $2,511.89 | $4,786.30 |