- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.61 / $7,863.94 / $20,680.40
| Facility | | $390.61 | $7,863.94 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,674.32 / $11,128.70 / $28,793.26
| Facility | | $6,674.32 | $11,128.70 | $28,793.26 |
- 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
- $297.44 / $513.87 / $5,715.32
| Facility | | $297.44 | $513.87 | $5,715.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.35 / $409.79 / $434.52
| Facility | | $319.35 | $409.79 | $434.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.47 / $289.47 / $291.11
| Facility | | $289.47 | $289.47 | $291.11 |
- 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 |