- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,630.78 / $12,022.64
| Facility | | $933.25 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,762.47 / $15,135.61
| Facility | | $4,265.80 | $7,762.47 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $4,570.88 / $4,570.88
| Facility | | $691.83 | $4,570.88 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $4,168.69 / $4,168.69
| Facility | | $4,168.69 | $4,168.69 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $45,708.82 / $45,708.82
| Facility | | $16,595.87 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,202.26 / $4,677.35
| Facility | | $741.31 | $1,202.26 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,023.29 / $1,778.28
| Facility | | $707.95 | $1,023.29 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,760.83 / $13,803.84
| Facility | | $2,187.76 | $6,760.83 | $13,803.84 |