- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,715.35 / $12,022.64
| Facility | | $870.96 | $3,715.35 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $7,244.36 / $14,125.38
| Facility | | $3,467.37 | $7,244.36 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $416.87
| Facility | | $389.05 | $389.05 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $5,248.07 / $7,079.46
| Facility | | $758.58 | $5,248.07 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $45,708.82 / $45,708.82
| Facility | | $27,542.29 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $660.69 / $1,905.46
| Facility | | $436.52 | $660.69 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $630.96 / $1,096.48
| Facility | | $436.52 | $630.96 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,128.31 / $17,378.01
| Facility | | $2,630.27 | $8,128.31 | $17,378.01 |