- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.20 / $3,908.01 / $13,841.56
| Facility | | $572.20 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.61 / $4,406.97 / $8,524.51
| Facility | | $3,350.61 | $4,406.97 | $8,524.51 |
- 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
- $532.29 / $972.74 / $2,760.44
| Facility | | $532.29 | $972.74 | $2,760.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.00 / $1,401.01 / $2,842.49
| Facility | | $1,110.00 | $1,401.01 | $2,842.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.66 / $3,093.00 / $7,934.00
| Facility | | $2,529.66 | $3,093.00 | $7,934.00 |