- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,019.95 / $7,413.10
| Facility | | $831.76 | $3,019.95 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,754.23 / $5,370.32
| Facility | | $1,584.89 | $2,754.23 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $398.11 / $407.38
| Facility | | $79.43 | $398.11 | $407.38 |
- 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
- $407.38 / $588.84 / $3,715.35
| Facility | | $407.38 | $588.84 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $512.86 / $891.25
| Facility | | $389.05 | $512.86 | $891.25 |
- 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 |