- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.38 / $8,042.03 / $19,276.96
| Facility | | $691.38 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,003.91 / $9,212.06 / $17,819.09
| Facility | | $7,003.91 | $9,212.06 | $17,819.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.27 / $623.29 / $4,803.10
| Facility | | $346.27 | $623.29 | $4,803.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.00 / $1,022.05 / $2,961.89
| Facility | | $667.00 | $1,022.05 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |