- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,715.35 / $8,317.64
| Facility | | $724.44 | $3,715.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $912.01 / $1,778.28
| Facility | | $489.78 | $912.01 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,691.53 / $8,317.64
| Facility | | $831.76 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $489.78 / $602.56
| Facility | | $416.87 | $489.78 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $436.52 / $537.03
| Facility | | $295.12 | $436.52 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,905.46 / $4,265.80
| Facility | | $549.54 | $1,905.46 | $4,265.80 |