- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $916.04 / $1,370.71 / $7,845.43
| Facility | | $916.04 | $1,370.71 | $7,845.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,474.86 / $3,474.86 / $3,525.56
| Facility | | $3,474.86 | $3,474.86 | $3,525.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $5,006.99
| Facility | | $606.10 | $606.10 | $5,006.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.00 / $1,074.69 / $1,826.97
| Facility | | $630.00 | $1,074.69 | $1,826.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,301.38 / $6,301.38 / $26,542.00
| Facility | | $6,301.38 | $6,301.38 | $26,542.00 |