- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $7,762.47
| Facility | | $741.31 | $741.31 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $11,748.98 / $26,915.35
| Facility | | $4,466.84 | $11,748.98 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,691.53 / $6,456.54
| Facility | | $1,905.46 | $2,691.53 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,570.40 / $5,128.61
| Facility | | $2,089.30 | $2,570.40 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,513.56 / $9,772.37
| Facility | | $758.58 | $1,513.56 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $7,943.28 / $12,589.25
| Facility | | $4,168.69 | $7,943.28 | $12,589.25 |