- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,630.78 / $12,022.64
| Facility | | $870.96 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $3,235.94 / $6,456.54
| Facility | | $1,698.24 | $3,235.94 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $363.08 / $380.19
| Facility | | $363.08 | $363.08 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,548.82
| Facility | | $1,479.11 | $1,479.11 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $45,708.82 / $45,708.82
| Facility | | $6,918.31 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $758.58 / $4,786.30
| Facility | | $407.38 | $758.58 | $4,786.30 |
- 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
- $676.08 / $2,511.89 / $4,786.30
| Facility | | $676.08 | $2,511.89 | $4,786.30 |