- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,818.38 / $8,317.64
| Facility | | $707.95 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,786.30 / $9,332.54
| Facility | | $2,398.83 | $4,786.30 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $4,570.88 / $4,570.88
| Facility | | $288.40 | $4,570.88 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $2,290.87 / $2,691.53
| Facility | | $562.34 | $2,290.87 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $28,840.32 / $28,840.32
| Facility | | $10,715.19 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $478.63 / $1,862.09
| Facility | | $323.59 | $478.63 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $457.09 / $794.33
| Facility | | $316.23 | $457.09 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,981.07 / $8,511.38
| Facility | | $1,380.38 | $3,981.07 | $8,511.38 |