- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $3,019.95 / $7,413.10
| Facility | | $776.25 | $3,019.95 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,168.69 / $7,943.28
| Facility | | $2,187.76 | $4,168.69 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $489.78 / $489.78
| Facility | | $79.43 | $489.78 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $28,840.32 / $28,840.32
| Facility | | $7,943.28 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $776.25 / $4,365.16
| Facility | | $524.81 | $776.25 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $645.65 / $1,023.29
| Facility | | $501.19 | $645.65 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |