- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $4,677.35 / $10,471.29
| Facility | | $891.25 | $4,677.35 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $11,481.54 / $18,620.87
| Facility | | $4,786.30 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,995.26 / $8,912.51
| Facility | | $912.01 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,096.48 / $50,118.72
| Facility | | $1,096.48 | $1,096.48 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $758.58 / $2,290.87
| Facility | | $630.96 | $758.58 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,737.80
| Facility | | $1,412.54 | $1,412.54 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $50,118.72 / $75,857.76
| Facility | | $741.31 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,888.44 / $14,791.08
| Facility | | $2,398.83 | $5,888.44 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $776.25 / $3,162.28
| Facility | | $524.81 | $776.25 | $3,162.28 |