- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,951.21 / $7,413.10
| Facility | | $707.95 | $2,951.21 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,168.69 / $8,128.31
| Facility | | $2,137.96 | $4,168.69 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $316.23 / $316.23
| Facility | | $79.43 | $316.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $28,840.32 / $28,840.32
| Facility | | $8,912.51 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $588.84 / $2,454.71
| Facility | | $354.81 | $588.84 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $549.54 / $912.01
| Facility | | $354.81 | $549.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |