- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,715.35 / $12,882.50
| Facility | | $977.24 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,691.53 / $5,495.41
| Facility | | $1,584.89 | $2,691.53 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $295.12 / $446.68
| Facility | | $295.12 | $295.12 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $33,884.42 / $33,884.42
| Facility | | $5,623.41 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $489.78 / $4,073.80
| Facility | | $309.03 | $489.78 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $436.52 / $676.08
| Facility | | $295.12 | $436.52 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |