- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $3,090.30 / $5,128.61
| Facility | | $1,288.25 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $5,011.87 / $9,332.54
| Facility | | $56.23 | $5,011.87 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $691.83
| Facility | | $295.12 | $295.12 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $363.08 / $7,079.46
| Facility | | $177.83 | $363.08 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $5,248.07 / $9,332.54
| Facility | | $56.23 | $5,248.07 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $11,220.18
| Facility | | $2,041.74 | $5,248.07 | $11,220.18 |