- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,715.35 / $12,882.50
| Facility | | $977.24 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,754.23 / $5,495.41
| Facility | | $1,445.44 | $2,754.23 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $8,912.51
| Facility | | $54.95 | $56.23 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,122.02 / $5,128.61
| Facility | | $707.95 | $1,122.02 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $933.25 / $1,659.59
| Facility | | $691.83 | $933.25 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,819.70 / $4,365.16
| Facility | | $436.52 | $1,819.70 | $4,365.16 |