- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.70 / $8,042.03 / $19,276.96
| Facility | | $558.70 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,362.84 / $10,999.42 / $21,276.43
| Facility | | $8,362.84 | $10,999.42 | $21,276.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,097.37 / $7,097.37 / $7,097.37
| Facility | | $7,097.37 | $7,097.37 | $7,097.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.15 / $765.26 / $2,029.52
| Facility | | $478.15 | $765.26 | $2,029.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $957.06 / $1,314.41 / $7,975.67
| Facility | | $957.06 | $1,314.41 | $7,975.67 |
- 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 |