- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,511.89 / $7,413.10
| Facility | | $630.96 | $2,511.89 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,698.24 / $3,388.44
| Facility | | $954.99 | $1,698.24 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $194.98
| Facility | | $181.97 | $181.97 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $831.76 / $1,071.52
| Facility | | $331.13 | $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
- $186.21 / $263.03 / $1,380.38
| Facility | | $186.21 | $263.03 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $245.47 / $436.52
| Facility | | $186.21 | $245.47 | $436.52 |
- 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 |