- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.36 / $8,477.27 / $20,928.72
| Facility | | $594.36 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,952.65 / $9,144.62 / $17,688.66
| Facility | | $6,952.65 | $9,144.62 | $17,688.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $594.36 / $1,099.57 / $4,636.80
| Facility | | $594.36 | $1,099.57 | $4,636.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.65 / $1,484.49 / $2,076.29
| Facility | | $789.65 | $1,484.49 | $2,076.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |