- 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
- $3,981.07 / $8,912.51 / $17,782.79
| Facility | | $3,981.07 | $8,912.51 | $17,782.79 |
- 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
- $19,952.62 / $45,708.82 / $45,708.82
| Facility | | $19,952.62 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $933.25 / $3,890.45
| Facility | | $630.96 | $933.25 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $870.96 / $1,445.44
| Facility | | $616.60 | $870.96 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $11,220.18
| Facility | | $1,698.24 | $5,248.07 | $11,220.18 |