- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.78 / $4,778.89 / $13,841.56
| Facility | | $512.78 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.61 / $4,406.97 / $8,524.51
| Facility | | $3,350.61 | $4,406.97 | $8,524.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $463.28 / $857.07 / $1,392.66
| Facility | | $463.28 | $857.07 | $1,392.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $982.00 / $1,257.44 / $1,597.29
| Facility | | $982.00 | $1,257.44 | $1,597.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |