- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $3,311.31 / $9,549.93
| Facility | | $776.25 | $3,311.31 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,630.27 / $5,495.41
| Facility | | $1,513.56 | $2,630.27 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $302.00
| Facility | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,412.54
| Facility | | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $28,840.32 / $28,840.32
| Facility | | $5,623.41 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $977.24 / $6,025.60
| Facility | | $380.19 | $977.24 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $467.74 / $794.33
| Facility | | $338.84 | $467.74 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |