- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $4,168.69 / $8,128.31
| Facility | | $2,187.76 | $4,168.69 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,890.45 / $15,488.17
| Facility | | $56.23 | $3,890.45 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $512.86 / $1,202.26
| Facility | | $512.86 | $512.86 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $741.31 / $13,803.84
| Facility | | $676.08 | $741.31 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $851.14 / $7,079.46
| Facility | | $380.19 | $851.14 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $5,888.44 / $15,488.17
| Facility | | $851.14 | $5,888.44 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $3,890.45 / $15,488.17
| Facility | | $56.23 | $3,890.45 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $6,025.60 / $16,595.87
| Facility | | $2,089.30 | $6,025.60 | $16,595.87 |