- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.34 / $8,477.27 / $20,928.72
| Facility | | $537.34 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,281.85 / $5,631.80 / $10,893.72
| Facility | | $4,281.85 | $5,631.80 | $10,893.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.34 / $940.35 / $1,624.17
| Facility | | $537.34 | $940.35 | $1,624.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.04 / $1,341.52 / $1,865.65
| Facility | | $702.04 | $1,341.52 | $1,865.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,056.00 / $1,527.00 / $4,317.00
| Facility | | $1,056.00 | $1,527.00 | $4,317.00 |