- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.17 / $4,786.30 / $12,022.64
| Facility | | $204.17 | $4,786.30 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $169.82 / $8,912.51
| Facility | | $169.82 | $169.82 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $208.93 / $50,118.72
| Facility | | $34.67 | $208.93 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $208.93 / $416.87
| Facility | | $128.82 | $208.93 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $50,118.72 / $75,857.76
| Facility | | $165.96 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,467.37 / $6,760.83
| Facility | | $1,698.24 | $3,467.37 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $151.36 / $275.42
| Facility | | $95.50 | $151.36 | $275.42 |