- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $7,943.28
| Facility | | $851.14 | $3,162.28 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,235.94 / $6,309.57
| Facility | | $1,862.09 | $3,235.94 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $575.44
| Facility | | $549.54 | $549.54 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,479.11
| Facility | | $1,479.11 | $1,479.11 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $28,840.32 / $28,840.32
| Facility | | $6,918.31 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $954.99 / $4,570.88
| Facility | | $588.84 | $954.99 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $758.58 / $1,288.25
| Facility | | $588.84 | $758.58 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,981.07 / $8,709.64
| Facility | | $1,258.93 | $3,981.07 | $8,709.64 |