- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,630.78 / $12,022.64
| Facility | | $870.96 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $4,677.35 / $8,912.51
| Facility | | $2,454.71 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $588.84
| Facility | | $302.00 | $302.00 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,511.89 / $2,818.38
| Facility | | $1,071.52 | $2,511.89 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $45,708.82 / $45,708.82
| Facility | | $11,220.18 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $794.33 / $2,290.87
| Facility | | $575.44 | $794.33 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $741.31 / $1,348.96
| Facility | | $562.34 | $741.31 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,011.87 / $10,964.78
| Facility | | $1,698.24 | $5,011.87 | $10,964.78 |