- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,570.40 / $3,715.35
| Facility | | $891.25 | $2,570.40 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,090.30 / $28,840.32
| Facility | | $562.34 | $3,090.30 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,513.56 / $1,995.26
| Facility | | $446.68 | $1,513.56 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.87 / $501.19 / $7,079.46
| Facility | | $223.87 | $501.19 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $3,162.28 / $8,511.38
| Facility | | $616.60 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $3,311.31 / $4,466.84
| Facility | | $1,202.26 | $3,311.31 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,090.30 / $28,840.32
| Facility | | $562.34 | $3,090.30 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,467.37 / $8,511.38
| Facility | | $676.08 | $3,467.37 | $8,511.38 |