- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,691.53 / $8,317.64
| Facility | | $501.19 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $794.33 / $8,128.31
| Facility | | $346.74 | $794.33 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $741.31
| Facility | | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,089.30 / $7,762.47
| Facility | | $537.03 | $2,089.30 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $407.38 / $1,000.00
| Facility | | $380.19 | $407.38 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $309.03 / $380.19
| Facility | | $309.03 | $309.03 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,951.21 / $16,982.44
| Facility | | $851.14 | $2,951.21 | $16,982.44 |