- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,801.89 / $8,317.64
| Facility | | $831.76 | $3,801.89 | $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
- $275.42 / $275.42 / $275.42
| Facility | | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $3,630.78
| Facility | | $2,398.83 | $2,398.83 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,691.53 / $8,317.64
| Facility | | $912.01 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $245.47 / $758.58
| Facility | | $245.47 | $245.47 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.49 / $331.13 / $416.87
| Facility | | $158.49 | $331.13 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $1,778.28 / $3,890.45
| Facility | | $467.74 | $1,778.28 | $3,890.45 |