- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.06 / $4,778.89 / $13,841.56
| Facility | | $712.06 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,522.85 / $8,579.33 / $16,595.18
| Facility | | $6,522.85 | $8,579.33 | $16,595.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,091.67 / $2,091.67 / $2,091.67
| Facility | | $2,091.67 | $2,091.67 | $2,091.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.85 / $1,090.73 / $4,037.06
| Facility | | $640.85 | $1,090.73 | $4,037.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,292.00 / $1,708.88 / $2,389.42
| Facility | | $1,292.00 | $1,708.88 | $2,389.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |