- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $304.93 / $7,928.29 / $14,833.44
| Facility | | $304.93 | $7,928.29 | $14,833.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $876.16 / $8,859.76 / $22,922.83
| Facility | | $876.16 | $8,859.76 | $22,922.83 |
- 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
- $233.21 / $406.64 / $2,679.56
| Facility | | $233.21 | $406.64 | $2,679.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.43 / $445.05 / $554.76
| Facility | | $283.43 | $445.05 | $554.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.99 / $378.40 / $1,367.95
| Facility | | $375.99 | $378.40 | $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 |