- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,148.15 / $8,912.51
| Facility | | $977.24 | $1,148.15 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,748.98 / $26,915.35
| Facility | | $4,897.79 | $11,748.98 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $4,168.69 / $9,772.37
| Facility | | $2,951.21 | $4,168.69 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $3,981.07 / $7,762.47
| Facility | | $3,162.28 | $3,981.07 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,737.80 / $4,265.80
| Facility | | $891.25 | $1,737.80 | $4,265.80 |
- 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 |