- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,019.95 / $7,943.28
| Facility | | $794.33 | $3,019.95 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $8,709.64 / $16,595.87
| Facility | | $3,890.45 | $8,709.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Facility | | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $4,786.30 / $4,786.30
| Facility | | $4,786.30 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $19,054.61
| Facility | | $54.95 | $56.23 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $758.58 / $4,786.30
| Facility | | $204.17 | $758.58 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $257.04 / $489.78
| Facility | | $190.55 | $257.04 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $11,220.18
| Facility | | $1,698.24 | $5,248.07 | $11,220.18 |