- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,951.21 / $6,918.31
| Facility | | $758.58 | $2,951.21 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,265.80 / $7,943.28
| Facility | | $2,238.72 | $4,265.80 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $562.34 / $562.34
| Facility | | $79.43 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $28,840.32 / $28,840.32
| Facility | | $7,943.28 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $933.25 / $2,511.89
| Facility | | $630.96 | $933.25 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $891.25 / $1,513.56
| Facility | | $630.96 | $891.25 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |