- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $2,691.53 / $7,762.47
| Facility | | $338.84 | $2,691.53 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $3,162.28
| Facility | | $2,691.53 | $2,691.53 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $2,089.30 / $7,244.36
| Facility | | $371.54 | $2,089.30 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $457.09
| Facility | | $269.15 | $269.15 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $223.87 / $223.87
| Facility | | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $676.08 / $4,265.80
| Facility | | $144.54 | $676.08 | $4,265.80 |