- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,715.35 / $12,882.50
| Facility | | $977.24 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,202.26 / $7,585.78
| Facility | | $707.95 | $1,202.26 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $616.60 / $630.96
| Facility | | $79.43 | $616.60 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $4,570.88
| Facility | | $54.95 | $56.23 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $933.25 / $2,884.03
| Facility | | $645.65 | $933.25 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $891.25 / $1,548.82
| Facility | | $645.65 | $891.25 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $10,715.19 / $22,908.68
| Facility | | $4,570.88 | $10,715.19 | $22,908.68 |