- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $956.50 / $4,778.89 / $13,841.56
| Facility | | $956.50 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,949.61 / $3,879.54 / $7,504.28
| Facility | | $2,949.61 | $3,879.54 | $7,504.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91.18 / $168.68 / $1,242.00
| Facility | | $91.18 | $168.68 | $1,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.63 / $234.68 / $953.00
| Facility | | $156.63 | $234.68 | $953.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |