- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.78 / $4,241.22 / $13,841.56
| Facility | | $543.78 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,531.27 / $9,468.52 / $16,616.63
| Facility | | $6,531.27 | $9,468.52 | $16,616.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $392.00 / $653.10 / $1,101.86
| Facility | | $392.00 | $653.10 | $1,101.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $1,134.63 / $1,478.33
| Facility | | $789.00 | $1,134.63 | $1,478.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |