- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.40 / $3,908.01 / $18,634.56
| Facility | | $397.40 | $3,908.01 | $18,634.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,303.68 / $6,975.78 / $13,493.42
| Facility | | $5,303.68 | $6,975.78 | $13,493.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.66 / $595.76 / $1,622.00
| Facility | | $357.66 | $595.76 | $1,622.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.51 / $966.56 / $1,541.96
| Facility | | $703.51 | $966.56 | $1,541.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |