- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.05 / $7,863.94 / $20,680.40
| Facility | | $708.05 | $7,863.94 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,674.32 / $11,128.70 / $21,287.95
| Facility | | $6,674.32 | $11,128.70 | $21,287.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,627.88 / $4,627.88 / $4,627.88
| Facility | | $4,627.88 | $4,627.88 | $4,627.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.36 / $886.47 / $5,715.32
| Facility | | $523.36 | $886.47 | $5,715.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.89 / $738.60 / $784.72
| Facility | | $568.89 | $738.60 | $784.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.76 / $522.76 / $526.46
| Facility | | $522.76 | $522.76 | $526.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,216.46 / $10,881.75 / $21,287.95
| Facility | | $7,216.46 | $10,881.75 | $21,287.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $6,594.00 / $12,835.00
| Facility | | $2,155.00 | $6,594.00 | $12,835.00 |