- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,454.71 / $6,918.31
| Facility | | $575.44 | $2,454.71 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,511.89 / $5,248.07
| Facility | | $1,412.54 | $2,511.89 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $117.49 / $436.52
| Facility | | $117.49 | $117.49 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $1,148.15 / $1,445.44
| Facility | | $223.87 | $1,148.15 | $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 / $316.23 / $933.25
| Facility | | $134.90 | $316.23 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $269.15 / $676.08
| Facility | | $134.90 | $269.15 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,890.45 / $8,511.38
| Facility | | $1,380.38 | $3,890.45 | $8,511.38 |