- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,511.89 / $6,918.31
| Facility | | $660.69 | $2,511.89 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,089.30 / $4,073.80
| Facility | | $1,258.93 | $2,089.30 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $1,023.29 / $1,023.29
| Facility | | $177.83 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $19,498.45 / $19,498.45
| Facility | | $4,786.30 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $295.12 / $3,162.28
| Facility | | $190.55 | $295.12 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $257.04 / $426.58
| Facility | | $186.21 | $257.04 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |