- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $2,187.76 / $3,801.89
| Facility | | $263.03 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $3,801.89
| Facility | | $56.23 | $1,258.93 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $398.11
| Facility | | $173.78 | $173.78 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $223.87 / $7,079.46
| Facility | | $134.90 | $223.87 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $2,511.89 / $7,079.46
| Facility | | $1,096.48 | $2,511.89 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,258.93 / $3,801.89
| Facility | | $56.23 | $1,258.93 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,344.23 / $6,165.95
| Facility | | $954.99 | $2,344.23 | $6,165.95 |