- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.53 / $6,072.60 / $14,556.34
| Facility | | $213.53 | $6,072.60 | $14,556.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,089.03 / $9,044.98 / $16,947.71
| Facility | | $5,089.03 | $9,044.98 | $16,947.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,380.38 / $2,380.38 / $3,965.68
| Facility | | $2,380.38 | $2,380.38 | $3,965.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.38 / $409.69 / $5,198.37
| Facility | | $226.38 | $409.69 | $5,198.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.04 / $347.73 / $371.14
| Facility | | $266.04 | $347.73 | $371.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.36 / $250.89 / $1,367.95
| Facility | | $242.36 | $250.89 | $1,367.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,745.15 / $8,854.69 / $16,947.71
| Facility | | $5,745.15 | $8,854.69 | $16,947.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $2,431.00 / $11,261.00
| Facility | | $1,550.00 | $2,431.00 | $11,261.00 |