- 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
- $2,570.40 / $4,570.88 / $9,120.11
| Facility | | $2,570.40 | $4,570.88 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $33,884.42 / $33,884.42
| Facility | | $8,709.64 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $831.76 / $5,128.61
| Facility | | $436.52 | $831.76 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $602.56 / $1,096.48
| Facility | | $407.38 | $602.56 | $1,096.48 |
- 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 |