- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,511.89 / $7,585.78
| Facility | | $707.95 | $2,511.89 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,265.80 / $7,413.10
| Facility | | $1,698.24 | $4,265.80 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $630.96 / $630.96
| Facility | | $79.43 | $630.96 | $630.96 |
- 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
- $602.56 / $851.14 / $3,162.28
| Facility | | $602.56 | $851.14 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $794.33 / $1,288.25
| Facility | | $588.84 | $794.33 | $1,288.25 |
- 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 |