- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,511.89 / $6,918.31
| Facility | | $630.96 | $2,511.89 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $2,454.71 / $4,677.35
| Facility | | $1,230.27 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $1,819.70 / $1,819.70
| Facility | | $123.03 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $1,122.02 / $1,445.44
| Facility | | $234.42 | $1,122.02 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $19,498.45 / $19,498.45
| Facility | | $4,897.79 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $239.88 / $1,202.26
| Facility | | $134.90 | $239.88 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $223.87 / $426.58
| Facility | | $134.90 | $223.87 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |