- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,818.38 / $5,128.61
| Facility | | $1,258.93 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,162.28 / $11,220.18
| Facility | | $56.23 | $3,162.28 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $870.96
| Facility | | $371.54 | $371.54 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $8,912.51
| Facility | | $676.08 | $741.31 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $616.60 / $7,079.46
| Facility | | $302.00 | $616.60 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,570.88 / $11,220.18
| Facility | | $645.65 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,162.28 / $11,220.18
| Facility | | $56.23 | $3,162.28 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $5,011.87 / $12,022.64
| Facility | | $1,659.59 | $5,011.87 | $12,022.64 |