- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.86 / $4,778.89 / $13,841.56
| Facility | | $652.86 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,018.72 / $10,546.81 / $20,400.93
| Facility | | $8,018.72 | $10,546.81 | $20,400.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.86 / $1,175.15 / $8,632.00
| Facility | | $652.86 | $1,175.15 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,640.04 / $6,616.19
| Facility | | $953.00 | $1,640.04 | $6,616.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |