- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $7,244.36 / $16,595.87
| Facility | | $537.03 | $7,244.36 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,398.83 / $4,265.80
| Facility | | $1,071.52 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,041.74 / $2,630.27
| Facility | | $2,041.74 | $2,041.74 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $288.40 / $467.74
| Facility | | $199.53 | $288.40 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |