- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.50 / $4,778.89 / $13,841.56
| Facility | | $509.50 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.44 / $636.88 / $2,554.92
| Facility | | $393.44 | $636.88 | $2,554.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.76 / $1,216.86 / $2,163.42
| Facility | | $802.76 | $1,216.86 | $2,163.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |