- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,548.13 / $11,481.54
| Facility | | $812.83 | $3,548.13 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $5,011.87 / $9,549.93
| Facility | | $2,754.23 | $5,011.87 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $1,905.46 / $2,754.23
| Facility | | $1,905.46 | $1,905.46 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $2,951.21 / $2,951.21
| Facility | | $309.03 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $45,708.82 / $45,708.82
| Facility | | $9,549.93 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $794.33 / $6,025.60
| Facility | | $346.74 | $794.33 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $446.68 / $776.25
| Facility | | $323.59 | $446.68 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $10,964.78
| Facility | | $1,698.24 | $5,248.07 | $10,964.78 |