- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,162.28 / $7,943.28
| Facility | | $794.33 | $3,162.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,818.38 / $5,754.40
| Facility | | $1,584.89 | $2,818.38 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $549.54 / $549.54
| Facility | | $79.43 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $28,840.32 / $28,840.32
| Facility | | $5,248.07 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $812.83 / $3,715.35
| Facility | | $562.34 | $812.83 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $741.31 / $1,288.25
| Facility | | $549.54 | $741.31 | $1,288.25 |
- 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 |