- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.41 / $4,778.89 / $13,841.56
| Facility | | $521.41 | $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
- $405.92 / $651.78 / $2,628.78
| Facility | | $405.92 | $651.78 | $2,628.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.22 / $1,266.36 / $2,163.42
| Facility | | $820.22 | $1,266.36 | $2,163.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |