- 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
- $2,511.89 / $4,466.84 / $9,120.11
| Facility | | $2,511.89 | $4,466.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $645.65
| Facility | | $645.65 | $645.65 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $9,332.54
| Facility | | $54.95 | $56.23 | $9,332.54 |
- 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
- $676.08 / $954.99 / $1,698.24
| Facility | | $676.08 | $954.99 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $10,964.78
| Facility | | $1,698.24 | $5,248.07 | $10,964.78 |