- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $7,585.78
| Facility | | $724.44 | $2,511.89 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $6,606.93 / $13,182.57
| Facility | | $3,467.37 | $6,606.93 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $549.54
| Facility | | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $6,918.31 / $6,918.31
| Facility | | $6,918.31 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $19,498.45 / $26,915.35
| Facility | | $19,498.45 | $19,498.45 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $977.24 / $3,890.45
| Facility | | $588.84 | $977.24 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $812.83 / $1,412.54
| Facility | | $588.84 | $812.83 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $11,220.18
| Facility | | $1,698.24 | $5,248.07 | $11,220.18 |