- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,467.37 / $12,022.64
| Facility | | $794.33 | $3,467.37 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,691.53 / $5,495.41
| Facility | | $1,548.82 | $2,691.53 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $457.09 / $467.74
| Facility | | $79.43 | $457.09 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $45,708.82 / $45,708.82
| Facility | | $5,623.41 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $741.31 / $2,754.23
| Facility | | $489.78 | $741.31 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $691.83 / $1,174.90
| Facility | | $489.78 | $691.83 | $1,174.90 |
- 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 |