- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,265.80 / $10,471.29
| Facility | | $776.25 | $4,265.80 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,762.47 / $13,803.84
| Facility | | $4,073.80 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,995.26 / $8,912.51
| Facility | | $707.95 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,862.09 / $50,118.72
| Facility | | $891.25 | $1,862.09 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $724.44 / $2,187.76
| Facility | | $616.60 | $724.44 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $50,118.72 / $75,857.76
| Facility | | $478.63 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,888.44 / $15,135.61
| Facility | | $2,398.83 | $5,888.44 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $602.56 / $1,737.80
| Facility | | $416.87 | $602.56 | $1,737.80 |