- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,019.95 / $7,943.28
| Facility | | $912.01 | $3,019.95 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,801.89 / $7,943.28
| Facility | | $2,238.72 | $3,801.89 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $933.25
| Facility | | $870.96 | $870.96 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,862.09 / $2,344.23
| Facility | | $1,584.89 | $1,862.09 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $7,943.28
| Facility | | $54.95 | $56.23 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,202.26 / $2,570.40
| Facility | | $891.25 | $1,202.26 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,148.15 / $2,041.74
| Facility | | $891.25 | $1,148.15 | $2,041.74 |
- 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 |