- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $2,238.72 / $3,801.89
| Facility | | $398.11 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $5,128.61 / $19,498.45
| Facility | | $741.31 | $5,128.61 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $354.81 / $812.83
| Facility | | $354.81 | $354.81 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $588.84 / $7,079.46
| Facility | | $281.84 | $588.84 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,265.80 / $9,772.37
| Facility | | $1,995.26 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $5,370.32 / $19,498.45
| Facility | | $741.31 | $5,370.32 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $11,220.18
| Facility | | $1,862.09 | $4,265.80 | $11,220.18 |