- 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
- $1,318.26 / $2,238.72 / $4,570.88
| Facility | | $1,318.26 | $2,238.72 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $436.52 / $436.52
| Facility | | $79.43 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $45,708.82 / $45,708.82
| Facility | | $4,786.30 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $602.56 / $3,890.45
| Facility | | $436.52 | $602.56 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $537.03 / $870.96
| Facility | | $416.87 | $537.03 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |