- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,951.21 / $7,413.10
| Facility | | $794.33 | $2,951.21 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,454.71 / $4,677.35
| Facility | | $1,318.26 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $1,230.27 / $1,230.27
| Facility | | $213.80 | $1,230.27 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,148.15 / $1,445.44
| Facility | | $407.38 | $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
- $234.42 / $346.74 / $1,737.80
| Facility | | $234.42 | $346.74 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $331.13 / $588.84
| Facility | | $234.42 | $331.13 | $588.84 |
- 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 |