- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $3,162.28 / $8,317.64
| Facility | | $588.84 | $3,162.28 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,570.40 / $57,543.99
| Facility | | $2,344.23 | $2,570.40 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $4,073.80 / $18,197.01
| Facility | | $3,388.44 | $4,073.80 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,454.71 / $7,762.47
| Facility | | $575.44 | $2,454.71 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $1,659.59
| Facility | | $691.83 | $691.83 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $309.03 / $707.95
| Facility | | $112.20 | $309.03 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,754.23 / $6,165.95
| Facility | | $1,000.00 | $2,754.23 | $6,165.95 |