- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,548.13 / $12,022.64
| Facility | | $870.96 | $3,548.13 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,365.16 / $8,317.64
| Facility | | $2,238.72 | $4,365.16 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $977.24 / $977.24
| Facility | | $549.54 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $45,708.82 / $45,708.82
| Facility | | $8,912.51 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $794.33 / $3,890.45
| Facility | | $562.34 | $794.33 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $724.44 / $1,148.15
| Facility | | $549.54 | $724.44 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,897.79
| Facility | | $724.44 | $2,511.89 | $4,897.79 |