- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $8,912.51 / $11,748.98
| Facility | | $263.03 | $8,912.51 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,388.44 / $7,943.28
| Facility | | $1,348.96 | $3,388.44 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $251.19 / $295.12
| Facility | | $251.19 | $251.19 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $398.11 / $21,379.62
| Facility | | $309.03 | $398.11 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,090.30 / $6,760.83
| Facility | | $1,479.11 | $3,090.30 | $6,760.83 |