- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $2,511.89 / $7,244.36
| Facility | | $645.65 | $2,511.89 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,630.27 / $5,248.07
| Facility | | $1,548.82 | $2,630.27 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,818.38 / $2,818.38
| Facility | | $436.52 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $19,498.45 / $19,498.45
| Facility | | $5,248.07 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $851.14 / $2,137.96
| Facility | | $467.74 | $851.14 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $794.33 / $1,348.96
| Facility | | $457.09 | $794.33 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |