- 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
- $1,148.15 / $2,187.76 / $4,466.84
| Facility | | $1,148.15 | $2,187.76 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $724.44 / $741.31
| Facility | | $79.43 | $724.44 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $45,708.82 / $45,708.82
| Facility | | $5,011.87 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,071.52 / $3,890.45
| Facility | | $758.58 | $1,071.52 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,023.29 / $1,737.80
| Facility | | $758.58 | $1,023.29 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $1,071.52 / $2,691.53
| Facility | | $162.18 | $1,071.52 | $2,691.53 |