- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,801.89 / $10,964.78
| Facility | | $794.33 | $3,801.89 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,025.60 / $12,302.69
| Facility | | $3,388.44 | $6,025.60 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $37,153.52
| Facility | | $794.33 | $794.33 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $977.24 / $50,118.72
| Facility | | $34.67 | $977.24 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $645.65 / $1,862.09
| Facility | | $457.09 | $645.65 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $50,118.72 / $75,857.76
| Facility | | $645.65 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,168.69 / $9,332.54
| Facility | | $1,513.56 | $4,168.69 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $616.60 / $1,778.28
| Facility | | $467.74 | $616.60 | $1,778.28 |