- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,951.21 / $8,317.64
| Facility | | $707.95 | $2,951.21 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,715.35 / $7,244.36
| Facility | | $2,041.74 | $3,715.35 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $3,311.31 / $3,311.31
| Facility | | $234.42 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $28,840.32 / $28,840.32
| Facility | | $6,760.83 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $446.68 / $3,715.35
| Facility | | $234.42 | $446.68 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $363.08 / $575.44
| Facility | | $223.87 | $363.08 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |