- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,691.53 / $8,317.64
| Facility | | $831.76 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $4,466.84 / $57,543.99
| Facility | | $3,801.89 | $4,466.84 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $812.83 / $812.83
| Facility | | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,570.88 / $5,248.07
| Facility | | $3,630.78 | $4,570.88 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,344.23 / $7,762.47
| Facility | | $724.44 | $2,344.23 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $1,698.24
| Facility | | $707.95 | $707.95 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $446.68 / $758.58
| Facility | | $309.03 | $446.68 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,311.31 / $6,309.57
| Facility | | $1,348.96 | $3,311.31 | $6,309.57 |