- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.30 / $4,557.00 / $8,110.53
| Facility | | $466.30 | $4,557.00 | $8,110.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,309.62 / $5,396.85 / $11,503.06
| Facility | | $2,309.62 | $5,396.85 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,133.95 / $1,608.90 / $3,870.44
| Facility | | $1,133.95 | $1,608.90 | $3,870.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.85 / $1,470.92 / $3,047.59
| Facility | | $1,030.85 | $1,470.92 | $3,047.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.96 / $809.12 / $3,991.00
| Facility | | $502.96 | $809.12 | $3,991.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $5,499.00 / $9,810.00
| Facility | | $3,121.00 | $5,499.00 | $9,810.00 |