- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.61 / $7,119.04 / $19,276.96
| Facility | | $536.61 | $7,119.04 | $19,276.96 |
- 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
- $453.01 / $806.18 / $1,918.16
| Facility | | $453.01 | $806.18 | $1,918.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $906.10 / $1,274.38 / $2,842.49
| Facility | | $906.10 | $1,274.38 | $2,842.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.66 / $5,356.00 / $7,934.00
| Facility | | $2,529.66 | $5,356.00 | $7,934.00 |