- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,090.30 / $5,128.61
| Facility | | $562.34 | $3,090.30 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,623.41 / $45,708.82
| Facility | | $977.24 | $5,623.41 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $1,148.15
| Facility | | $501.19 | $501.19 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $891.25 / $7,079.46
| Facility | | $407.38 | $891.25 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,248.07 / $11,220.18
| Facility | | $2,137.96 | $5,248.07 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,623.41 / $45,708.82
| Facility | | $977.24 | $5,623.41 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $5,248.07 / $10,715.19
| Facility | | $2,041.74 | $5,248.07 | $10,715.19 |