- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $3,715.35 / $8,511.38
| Facility | | $758.58 | $3,715.35 | $8,511.38 |
- 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
- $776.25 / $1,698.24 / $6,165.95
| Facility | | $776.25 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,659.59 / $50,118.72
| Facility | | $933.25 | $1,659.59 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $616.60 / $1,778.28
| Facility | | $436.52 | $616.60 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $50,118.72 / $75,857.76
| Facility | | $575.44 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,365.16 / $9,549.93
| Facility | | $2,041.74 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $660.69 / $2,290.87
| Facility | | $446.68 | $660.69 | $2,290.87 |