- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.89 / $4,518.60 / $13,841.56
| Facility | | $420.89 | $4,518.60 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- 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
- $287.89 / $526.13 / $1,314.24
| Facility | | $287.89 | $526.13 | $1,314.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $548.91 / $1,030.16 / $2,842.49
| Facility | | $548.91 | $1,030.16 | $2,842.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,038.98 / $4,803.10 / $7,772.00
| Facility | | $4,038.98 | $4,803.10 | $7,772.00 |