- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,019.95 / $7,413.10
| Facility | | $831.76 | $3,019.95 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $9,332.54 / $17,782.79
| Facility | | $3,801.89 | $9,332.54 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $549.54 / $549.54
| Facility | | $79.43 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $28,840.32 / $28,840.32
| Facility | | $19,952.62 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $954.99 / $3,715.35
| Facility | | $588.84 | $954.99 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $851.14 / $1,348.96
| Facility | | $575.44 | $851.14 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $9,120.11
| Facility | | $1,380.38 | $4,073.80 | $9,120.11 |