- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,454.71 / $7,585.78
| Facility | | $630.96 | $2,454.71 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,951.21 / $5,623.41
| Facility | | $1,737.80 | $2,951.21 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $186.21 / $186.21
| Facility | | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $5,495.41
| Facility | | $54.95 | $56.23 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,096.48 / $3,890.45
| Facility | | $223.87 | $1,096.48 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $912.01 / $2,089.30
| Facility | | $213.80 | $912.01 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,709.64
| Facility | | $1,380.38 | $4,073.80 | $8,709.64 |