- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,398.83 / $6,456.54
| Facility | | $724.44 | $2,398.83 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,073.80 / $5,888.44
| Facility | | $2,089.30 | $4,073.80 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $13,803.84 / $19,952.62
| Facility | | $12,302.69 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $10,232.93 / $10,232.93
| Facility | | $54.95 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $5,495.41 / $74,131.02
| Facility | | $2,818.38 | $5,495.41 | $74,131.02 |