- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $5,495.41 / $11,481.54
| Facility | | $223.87 | $5,495.41 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $9,120.11 / $26,915.35
| Facility | | $5,754.40 | $9,120.11 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $741.31 / $1,778.28
| Facility | | $524.81 | $741.31 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $724.44 / $1,412.54
| Facility | | $575.44 | $724.44 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $562.34 / $9,332.54
| Facility | | $331.13 | $562.34 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $6,025.60 / $10,715.19
| Facility | | $3,019.95 | $6,025.60 | $10,715.19 |