- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.41 / $4,955.18 / $8,091.88
| Facility | | $592.41 | $4,955.18 | $8,091.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,221.47 / $3,221.47 / $4,603.08
| Facility | | $3,221.47 | $3,221.47 | $4,603.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $592.41 / $858.00 / $1,311.30
| Facility | | $592.41 | $858.00 | $1,311.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,281.67 / $19,913.50 / $26,542.00
| Facility | | $2,281.67 | $19,913.50 | $26,542.00 |