- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,511.89 / $6,918.31
| Facility | | $588.84 | $2,511.89 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,715.35 / $7,079.46
| Facility | | $1,995.26 | $3,715.35 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $602.56
| Facility | | $416.87 | $416.87 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,698.24 / $1,995.26
| Facility | | $724.44 | $1,698.24 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $19,498.45 / $19,498.45
| Facility | | $7,943.28 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $616.60 / $1,288.25
| Facility | | $389.05 | $616.60 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $588.84 / $1,071.52
| Facility | | $371.54 | $588.84 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,981.07 / $8,511.38
| Facility | | $1,380.38 | $3,981.07 | $8,511.38 |