- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.84 / $8,042.03 / $19,276.96
| Facility | | $533.84 | $8,042.03 | $19,276.96 |
- 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
- $455.35 / $728.61 / $1,968.16
| Facility | | $455.35 | $728.61 | $1,968.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.40 / $1,265.54 / $2,842.49
| Facility | | $921.40 | $1,265.54 | $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 |