- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,168.69 / $7,244.36
| Facility | | $602.56 | $4,168.69 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,187.76 / $2,454.71
| Facility | | $1,905.46 | $2,187.76 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,659.59 / $2,884.03
| Facility | | $501.19 | $1,659.59 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $1,096.48 / $2,187.76
| Facility | | $363.08 | $1,096.48 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $5,128.61 / $14,125.38
| Facility | | $1,148.15 | $5,128.61 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $9,549.93 / $9,549.93
| Facility | | $56.23 | $9,549.93 | $9,549.93 |