- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,630.78 / $12,022.64
| Facility | | $870.96 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $4,265.80 / $8,128.31
| Facility | | $2,344.23 | $4,265.80 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $645.65 / $645.65
| Facility | | $79.43 | $645.65 | $645.65 |
- 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
- $676.08 / $1,047.13 / $3,890.45
| Facility | | $676.08 | $1,047.13 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $977.24 / $1,548.82
| Facility | | $676.08 | $977.24 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $10,964.78
| Facility | | $1,698.24 | $5,248.07 | $10,964.78 |