- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,511.89 / $6,918.31
| Facility | | $645.65 | $2,511.89 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,365.16 / $8,317.64
| Facility | | $2,398.83 | $4,365.16 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $512.86 / $512.86
| Facility | | $79.43 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $19,498.45 / $19,498.45
| Facility | | $8,912.51 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $724.44 / $3,162.28
| Facility | | $512.86 | $724.44 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $660.69 / $1,148.15
| Facility | | $512.86 | $660.69 | $1,148.15 |
- 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 |