- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $2,818.38 / $5,128.61
| Facility | | $208.93 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $3,981.07 / $28,840.32
| Facility | | $436.52 | $3,981.07 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $478.63
| Facility | | $213.80 | $213.80 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $501.19 / $7,079.46
| Facility | | $169.82 | $501.19 | $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
- $436.52 / $4,265.80 / $28,840.32
| Facility | | $436.52 | $4,265.80 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |