- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $7,943.28 / $20,892.96
| Facility | | $741.31 | $7,943.28 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,071.52 / $2,630.27
| Facility | | $891.25 | $1,071.52 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $794.33 / $2,454.71
| Facility | | $416.87 | $794.33 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $741.31 / $794.33
| Facility | | $616.60 | $741.31 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $537.03 / $602.56
| Facility | | $512.86 | $537.03 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $5,495.41 / $10,471.29
| Facility | | $3,890.45 | $5,495.41 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $6,760.83 / $11,220.18
| Facility | | $1,995.26 | $6,760.83 | $11,220.18 |