- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,630.78 / $12,022.64
| Facility | | $870.96 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,715.35 / $7,244.36
| Facility | | $2,041.74 | $3,715.35 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $660.69
| Facility | | $630.96 | $630.96 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,819.70 / $2,344.23
| Facility | | $1,122.02 | $1,819.70 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $45,708.82 / $45,708.82
| Facility | | $7,943.28 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $851.14 / $2,290.87
| Facility | | $630.96 | $851.14 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $812.83 / $1,380.38
| Facility | | $616.60 | $812.83 | $1,380.38 |
- 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 |