- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $3,090.30 / $5,623.41
| Facility | | $154.88 | $3,090.30 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $524.81 / $2,951.21
| Facility | | $56.23 | $524.81 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $1,380.38
| Facility | | $50.12 | $676.08 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $302.00 / $8,511.38
| Facility | | $144.54 | $302.00 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $1,819.70 / $3,467.37
| Facility | | $229.09 | $1,819.70 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $524.81 / $2,951.21
| Facility | | $56.23 | $524.81 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,698.24 / $2,818.38
| Facility | | $309.03 | $1,698.24 | $2,818.38 |