- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,511.89 / $8,317.64
| Facility | | $851.14 | $2,511.89 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $4,677.35 / $9,120.11
| Facility | | $2,290.87 | $4,677.35 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $707.95
| Facility | | $660.69 | $660.69 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,290.87 / $2,691.53
| Facility | | $1,023.29 | $2,290.87 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $19,498.45 / $19,498.45
| Facility | | $10,715.19 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $912.01 / $2,238.72
| Facility | | $660.69 | $912.01 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $870.96 / $1,513.56
| Facility | | $660.69 | $870.96 | $1,513.56 |
- 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 |