- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $9,332.54 / $28,183.83
| Facility | | $776.25 | $9,332.54 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $6,760.83
| Facility | | $2,290.87 | $2,290.87 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $851.14 / $7,244.36
| Facility | | $467.74 | $851.14 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $794.33 / $831.76
| Facility | | $676.08 | $794.33 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $10,715.19 / $10,715.19
| Facility | | $10,715.19 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,495.41 / $28,840.32
| Facility | | $1,412.54 | $5,495.41 | $28,840.32 |