- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,818.38 / $5,128.61
| Facility | | $436.52 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,897.79 / $28,840.32
| Facility | | $602.56 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $346.74 / $794.33
| Facility | | $346.74 | $346.74 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $630.96 / $7,079.46
| Facility | | $295.12 | $630.96 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,897.79 / $28,840.32
| Facility | | $602.56 | $4,897.79 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $9,772.37
| Facility | | $1,862.09 | $4,265.80 | $9,772.37 |