- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $2,818.38 / $5,128.61
| Facility | | $162.18 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $630.96 / $2,818.38
| Facility | | $56.23 | $630.96 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $66.07 / $154.88
| Facility | | $66.07 | $66.07 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57.54 / $177.83 / $7,079.46
| Facility | | $57.54 | $177.83 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $741.31 / $2,818.38
| Facility | | $56.23 | $741.31 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |