- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $7,762.47
| Facility | | $794.33 | $794.33 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,748.98 / $26,915.35
| Facility | | $5,011.87 | $11,748.98 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $3,019.95 / $7,244.36
| Facility | | $1,905.46 | $3,019.95 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,884.03 / $5,754.40
| Facility | | $2,344.23 | $2,884.03 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,258.93 / $2,818.38
| Facility | | $831.76 | $1,258.93 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,943.28 / $12,589.25
| Facility | | $2,951.21 | $7,943.28 | $12,589.25 |