- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $2,238.72 / $3,801.89
| Facility | | $371.54 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $4,677.35 / $19,498.45
| Facility | | $691.83 | $4,677.35 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $758.58
| Facility | | $331.13 | $331.13 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $549.54 / $7,079.46
| Facility | | $263.03 | $549.54 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $4,677.35 / $19,498.45
| Facility | | $691.83 | $4,677.35 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $10,715.19
| Facility | | $1,584.89 | $3,630.78 | $10,715.19 |