- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $635.89 / $8,477.27 / $20,928.72
| Facility | | $635.89 | $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
- $635.89 / $1,134.78 / $4,933.68
| Facility | | $635.89 | $1,134.78 | $4,933.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $834.29 / $1,581.98 / $2,213.94
| Facility | | $834.29 | $1,581.98 | $2,213.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |