- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.89 / $3,795.64 / $13,841.56
| Facility | | $462.89 | $3,795.64 | $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
- $193.40 / $193.40 / $193.40
| Facility | | $193.40 | $193.40 | $193.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.38 / $763.77 / $1,180.03
| Facility | | $426.38 | $763.77 | $1,180.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.08 / $1,040.02 / $1,431.81
| Facility | | $214.08 | $1,040.02 | $1,431.81 |
- 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 |