- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $3,630.78 / $8,317.64
| Facility | | $537.03 | $3,630.78 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $57,543.99
| Facility | | $3,801.89 | $3,801.89 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $162.18 / $162.18
| Facility | | $162.18 | $162.18 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $3,235.94 / $3,235.94
| Facility | | $3,235.94 | $3,235.94 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,691.53 / $8,317.64
| Facility | | $645.65 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $467.74
| Facility | | $151.36 | $151.36 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74.13 / $173.78 / $416.87
| Facility | | $74.13 | $173.78 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,691.53 / $5,888.44
| Facility | | $912.01 | $2,691.53 | $5,888.44 |