- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.32 / $8,042.03 / $19,276.96
| Facility | | $507.32 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,522.03 / $5,947.70 / $11,504.78
| Facility | | $4,522.03 | $5,947.70 | $11,504.78 |
- 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
- $453.32 / $711.13 / $1,948.80
| Facility | | $453.32 | $711.13 | $1,948.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $926.26 / $1,238.91 / $2,842.49
| Facility | | $926.26 | $1,238.91 | $2,842.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |