- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.25 / $9,185.68 / $20,928.72
| Facility | | $410.25 | $9,185.68 | $20,928.72 |
- 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
- $328.81 / $541.61 / $1,417.04
| Facility | | $328.81 | $541.61 | $1,417.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.48 / $954.88 / $2,842.49
| Facility | | $656.48 | $954.88 | $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 |