- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $3,467.37 / $11,481.54
| Facility | | $891.25 | $3,467.37 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,168.69 / $8,128.31
| Facility | | $2,187.76 | $4,168.69 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,235.94 / $7,413.10
| Facility | | $812.83 | $3,235.94 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $2,570.40 / $2,570.40
| Facility | | $346.74 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $45,708.82 / $45,708.82
| Facility | | $8,912.51 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $512.86 / $4,073.80
| Facility | | $354.81 | $512.86 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $446.68 / $758.58
| Facility | | $338.84 | $446.68 | $758.58 |
- 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 |