- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.12 / $3,028.31 / $6,896.35
| Facility | | $221.12 | $3,028.31 | $6,896.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.15 / $1,627.07 / $2,761.08
| Facility | | $1,479.15 | $1,627.07 | $2,761.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.36 / $1,362.98 / $2,709.73
| Facility | | $495.36 | $1,362.98 | $2,709.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.01 / $280.27 / $413.21
| Facility | | $155.01 | $280.27 | $413.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.90 / $1,083.90 / $26,542.00
| Facility | | $1,083.90 | $1,083.90 | $26,542.00 |