- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,238.72 / $5,128.61
| Facility | | $575.44 | $2,238.72 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $4,570.88 / $19,498.45
| Facility | | $1,096.48 | $4,570.88 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $1,621.81
| Facility | | $707.95 | $707.95 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $1,230.27 / $7,079.46
| Facility | | $380.19 | $1,230.27 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,630.78 / $8,511.38
| Facility | | $1,698.24 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $4,570.88 / $19,498.45
| Facility | | $1,318.26 | $4,570.88 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $8,511.38
| Facility | | $1,584.89 | $3,630.78 | $8,511.38 |