- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $848.76 / $1,349.17 / $13,271.66
| Facility | | $848.76 | $1,349.17 | $13,271.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,855.05 / $6,855.05 / $6,955.07
| Facility | | $6,855.05 | $6,855.05 | $6,955.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $15,887.16
| Facility | | $606.10 | $606.10 | $15,887.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $848.76 / $1,193.26 / $1,735.10
| Facility | | $848.76 | $1,193.26 | $1,735.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,865.76 / $45,827.50 / $52,504.25
| Facility | | $4,865.76 | $45,827.50 | $52,504.25 |