- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $3,801.89 / $6,025.60
| Facility | | $501.19 | $3,801.89 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,585.78 / $22,908.68
| Facility | | $4,365.16 | $7,585.78 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,511.89 / $5,888.44
| Facility | | $1,778.28 | $2,511.89 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $2,398.83 / $4,677.35
| Facility | | $1,905.46 | $2,398.83 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,023.29 / $2,754.23
| Facility | | $537.03 | $1,023.29 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,786.30 / $8,912.51
| Facility | | $2,398.83 | $4,786.30 | $8,912.51 |