- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $4,073.80 / $8,317.64
| Facility | | $851.14 | $4,073.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $3,801.89 / $57,543.99
| Facility | | $3,801.89 | $3,801.89 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $977.24 / $977.24
| Facility | | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,311.31 / $9,332.54
| Facility | | $2,137.96 | $3,311.31 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,630.78 / $7,762.47
| Facility | | $851.14 | $3,630.78 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $1,288.25
| Facility | | $660.69 | $660.69 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $478.63 / $758.58
| Facility | | $416.87 | $478.63 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,630.27 / $5,754.40
| Facility | | $912.01 | $2,630.27 | $5,754.40 |