- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,548.13 / $11,481.54
| Facility | | $724.44 | $3,548.13 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,585.78 / $22,908.68
| Facility | | $4,365.16 | $7,585.78 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,630.27 / $6,309.57
| Facility | | $1,862.09 | $2,630.27 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,511.89 / $4,897.79
| Facility | | $2,041.74 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,318.26 / $3,981.07
| Facility | | $676.08 | $1,318.26 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $3,467.37 / $7,079.46
| Facility | | $1,380.38 | $3,467.37 | $7,079.46 |