- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.13 / $7,119.04 / $19,276.96
| Facility | | $497.13 | $7,119.04 | $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
- $395.83 / $634.79 / $1,698.80
| Facility | | $395.83 | $634.79 | $1,698.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.76 / $1,184.84 / $2,842.49
| Facility | | $802.76 | $1,184.84 | $2,842.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,038.98 / $4,803.10 / $7,772.00
| Facility | | $4,038.98 | $4,803.10 | $7,772.00 |