- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.98 / $5,116.62 / $20,680.40
| Facility | | $554.98 | $5,116.62 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,844.35 / $4,594.55 / $11,887.47
| Facility | | $2,844.35 | $4,594.55 | $11,887.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,007.00 / $1,007.00 / $1,677.65
| Facility | | $1,007.00 | $1,007.00 | $1,677.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.44 / $693.96 / $4,702.87
| Facility | | $376.44 | $693.96 | $4,702.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.33 / $591.61 / $611.04
| Facility | | $441.33 | $591.61 | $611.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.08 / $416.78 / $625.69
| Facility | | $404.08 | $416.78 | $625.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,352.57 / $4,591.92 / $8,788.86
| Facility | | $3,352.57 | $4,591.92 | $8,788.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,740.00 / $5,794.90 / $9,269.08
| Facility | | $3,740.00 | $5,794.90 | $9,269.08 |