- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $2,238.72 / $5,623.41
| Facility | | $269.15 | $2,238.72 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $6,165.95 / $19,498.45
| Facility | | $302.00 | $6,165.95 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $269.15 / $616.60
| Facility | | $269.15 | $269.15 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $457.09 / $7,079.46
| Facility | | $213.80 | $457.09 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $6,165.95 / $19,498.45
| Facility | | $302.00 | $6,165.95 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $11,220.18
| Facility | | $2,041.74 | $5,248.07 | $11,220.18 |