- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $996.23 / $996.23 / $17,472.11
| Facility | | $996.23 | $996.23 | $17,472.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,293.73 / $11,253.87 / $25,424.06
| Facility | | $2,293.73 | $11,253.87 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,416.05 / $3,428.03 / $8,246.59
| Facility | | $2,416.05 | $3,428.03 | $8,246.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,196.41 / $3,134.04 / $6,493.38
| Facility | | $2,196.41 | $3,134.04 | $6,493.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,024.76 / $1,723.46 / $5,577.00
| Facility | | $1,024.76 | $1,723.46 | $5,577.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |