- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $4,677.35 / $10,232.93
| Facility | | $741.31 | $4,677.35 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,786.30 / $10,232.93
| Facility | | $2,630.27 | $4,786.30 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $758.58 / $10,964.78
| Facility | | $758.58 | $758.58 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $912.01 / $50,118.72
| Facility | | $34.67 | $912.01 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $758.58 / $1,905.46
| Facility | | $537.03 | $758.58 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $50,118.72 / $75,857.76
| Facility | | $489.78 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,365.16 / $9,549.93
| Facility | | $2,137.96 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $616.60 / $1,445.44
| Facility | | $436.52 | $616.60 | $1,445.44 |