- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $3,235.94 / $10,715.19
| Facility | | $707.95 | $3,235.94 | $10,715.19 |
- 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
- $812.83 / $3,162.28 / $6,456.54
| Facility | | $812.83 | $3,162.28 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $2,187.76 / $2,187.76
| Facility | | $177.83 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $45,708.82 / $45,708.82
| Facility | | $6,760.83 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $389.05 / $4,466.84
| Facility | | $181.97 | $389.05 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $288.40 / $501.19
| Facility | | $169.82 | $288.40 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,709.64
| Facility | | $1,380.38 | $4,073.80 | $8,709.64 |