- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $7,943.28 / $20,892.96
| Facility | | $977.24 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $870.96 / $4,466.84
| Facility | | $707.95 | $870.96 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,071.52 / $4,265.80
| Facility | | $537.03 | $1,071.52 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $977.24 / $1,047.13
| Facility | | $812.83 | $977.24 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $707.95 / $977.24
| Facility | | $691.83 | $707.95 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $9,120.11 / $17,378.01
| Facility | | $6,760.83 | $9,120.11 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $11,220.18 / $18,620.87
| Facility | | $2,454.71 | $11,220.18 | $18,620.87 |