- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $3,715.35 / $10,232.93
| Facility | | $630.96 | $3,715.35 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,698.24 / $6,165.95
| Facility | | $616.60 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,659.59 / $50,118.72
| Facility | | $758.58 | $1,659.59 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $616.60 / $1,548.82
| Facility | | $467.74 | $616.60 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $50,118.72 / $75,857.76
| Facility | | $467.74 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,365.16 / $9,772.37
| Facility | | $2,137.96 | $4,365.16 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $575.44 / $1,445.44
| Facility | | $363.08 | $575.44 | $1,445.44 |