- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,398.83 / $2,754.23
| Facility | | $1,659.59 | $2,398.83 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $97.72 / $100.00
| Facility | | $81.28 | $97.72 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $691.83 / $741.31
| Facility | | $602.56 | $691.83 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $213.80 / $19,054.61
| Facility | | $141.25 | $213.80 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $95.50 / $95.50
| Facility | | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,041.74 / $2,041.74
| Facility | | $2,041.74 | $2,041.74 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $724.44
| Facility | | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $25,703.96 / $63,095.73
| Facility | | $6,025.60 | $25,703.96 | $63,095.73 |