- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $706.36 / $9,185.68 / $20,928.72
| Facility | | $706.36 | $9,185.68 | $20,928.72 |
- 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
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.50 / $1,002.33 / $2,709.40
| Facility | | $629.50 | $1,002.33 | $2,709.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.35 / $1,678.30 / $7,050.50
| Facility | | $1,247.35 | $1,678.30 | $7,050.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,569.59 / $8,163.00 / $9,696.00
| Facility | | $5,569.59 | $8,163.00 | $9,696.00 |