- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.22 / $4,778.89 / $13,841.56
| Facility | | $574.22 | $4,778.89 | $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
- $463.73 / $730.68 / $2,003.08
| Facility | | $463.73 | $730.68 | $2,003.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $942.87 / $1,387.91 / $2,163.42
| Facility | | $942.87 | $1,387.91 | $2,163.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |