- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $2,238.72 / $3,801.89
| Facility | | $162.18 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $5,128.61 / $19,498.45
| Facility | | $338.84 | $5,128.61 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $371.54
| Facility | | $162.18 | $162.18 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $380.19 / $7,079.46
| Facility | | $131.83 | $380.19 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $5,370.32 / $19,498.45
| Facility | | $338.84 | $5,370.32 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,981.07 / $9,120.11
| Facility | | $1,862.09 | $3,981.07 | $9,120.11 |