- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $3,090.30 / $11,481.54
| Facility | | $346.74 | $3,090.30 | $11,481.54 |
- 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
- $295.12 / $295.12 / $13,489.63
| Facility | | $295.12 | $295.12 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $354.81 / $50,118.72
| Facility | | $34.67 | $354.81 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $295.12 / $724.44
| Facility | | $218.78 | $295.12 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $50,118.72 / $75,857.76
| Facility | | $257.04 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,918.31 / $23,988.33
| Facility | | $2,454.71 | $6,918.31 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $257.04 / $446.68
| Facility | | $165.96 | $257.04 | $446.68 |