- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.60 / $4,518.60 / $13,841.56
| Facility | | $506.60 | $4,518.60 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,712.35 / $6,198.03 / $11,988.99
| Facility | | $4,712.35 | $6,198.03 | $11,988.99 |
- 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
- $397.93 / $649.21 / $1,732.32
| Facility | | $397.93 | $649.21 | $1,732.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.94 / $1,164.47 / $2,842.49
| Facility | | $804.94 | $1,164.47 | $2,842.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |