- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $4,677.35 / $8,317.64
| Facility | | $891.25 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $13,803.84 / $16,595.87
| Facility | | $12,882.50 | $13,803.84 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $3,801.89 / $8,317.64
| Facility | | $891.25 | $3,801.89 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $1,047.13
| Facility | | $660.69 | $660.69 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $467.74 / $602.56
| Facility | | $467.74 | $467.74 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $15,488.17
| Facility | | $1,348.96 | $3,548.13 | $15,488.17 |