- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,511.89 / $7,585.78
| Facility | | $676.08 | $2,511.89 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $2,187.76 / $4,265.80
| Facility | | $1,288.25 | $2,187.76 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $588.84 / $602.56
| Facility | | $79.43 | $588.84 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $19,498.45 / $19,498.45
| Facility | | $4,786.30 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $870.96 / $3,311.31
| Facility | | $588.84 | $870.96 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $794.33 / $1,348.96
| Facility | | $588.84 | $794.33 | $1,348.96 |
- 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 |