- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,187.76 / $3,801.89
| Facility | | $575.44 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,479.11 / $3,801.89
| Facility | | $56.23 | $1,479.11 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $407.38
| Facility | | $173.78 | $173.78 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $223.87 / $7,079.46
| Facility | | $134.90 | $223.87 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,479.11 / $3,801.89
| Facility | | $56.23 | $1,479.11 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,089.30 / $6,165.95
| Facility | | $831.76 | $2,089.30 | $6,165.95 |