- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.54 / $1,176.09 / $3,104.59
| Facility | | $937.54 | $1,176.09 | $3,104.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,631.88 / $6,722.82 / $12,670.46
| Facility | | $4,631.88 | $6,722.82 | $12,670.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,269.11 / $1,269.11 / $1,269.11
| Facility | | $1,269.11 | $1,269.11 | $1,269.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.04 / $1,040.04 / $7,227.90
| Facility | | $1,040.04 | $1,040.04 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.00 / $1,516.21 / $2,640.00
| Facility | | $319.00 | $1,516.21 | $2,640.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $1,040.04 / $7,227.90
| Facility | | $555.00 | $1,040.04 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,749.00 / $4,194.00 / $9,300.00
| Facility | | $1,749.00 | $4,194.00 | $9,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $968.26 / $968.26 / $3,270.01
| Facility | | $968.26 | $968.26 | $3,270.01 |