- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.04 / $3,908.01 / $13,841.56
| Facility | | $406.04 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $277.16 / $466.95 / $1,799.58
| Facility | | $277.16 | $466.95 | $1,799.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.67 / $959.24 / $2,163.42
| Facility | | $567.67 | $959.24 | $2,163.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,562.76 / $4,236.79 / $7,772.00
| Facility | | $3,562.76 | $4,236.79 | $7,772.00 |