- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,467.37 / $12,022.64
| Facility | | $812.83 | $3,467.37 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,187.76 / $4,265.80
| Facility | | $1,096.48 | $2,187.76 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $181.97 / $707.95
| Facility | | $177.83 | $181.97 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $933.25 / $1,202.26
| Facility | | $346.74 | $933.25 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $3,981.07
| Facility | | $54.95 | $56.23 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $794.33 / $3,715.35
| Facility | | $223.87 | $794.33 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $645.65 / $1,318.26
| Facility | | $204.17 | $645.65 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |