- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $3,162.28 / $7,413.10
| Facility | | $776.25 | $3,162.28 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,511.89 / $4,677.35
| Facility | | $1,318.26 | $2,511.89 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $165.96 / $177.83
| Facility | | $165.96 | $165.96 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,148.15 / $1,445.44
| Facility | | $323.59 | $1,148.15 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $28,840.32 / $28,840.32
| Facility | | $4,897.79 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $269.15 / $1,737.80
| Facility | | $181.97 | $269.15 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $257.04 / $457.09
| Facility | | $181.97 | $257.04 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,786.30
| Facility | | $724.44 | $2,511.89 | $4,786.30 |