- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,235.94 / $8,128.31
| Facility | | $831.76 | $3,235.94 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,454.71 / $4,677.35
| Facility | | $1,258.93 | $2,454.71 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $269.15
| Facility | | $257.04 | $257.04 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,148.15 / $1,412.54
| Facility | | $501.19 | $1,148.15 | $1,412.54 |
- 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
- $281.84 / $416.87 / $1,778.28
| Facility | | $281.84 | $416.87 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $398.11 / $707.95
| Facility | | $281.84 | $398.11 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,511.89 / $4,786.30
| Facility | | $676.08 | $2,511.89 | $4,786.30 |