- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.18 / $2,868.12 / $6,613.61
| Facility | | $290.18 | $2,868.12 | $6,613.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,066.82 / $6,102.01 / $11,441.84
| Facility | | $3,066.82 | $6,102.01 | $11,441.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $681.88 / $1,064.24 / $2,560.17
| Facility | | $681.88 | $1,064.24 | $2,560.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.91 / $971.19 / $2,015.89
| Facility | | $590.91 | $971.19 | $2,015.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $320.27 / $621.46 / $3,805.08
| Facility | | $320.27 | $621.46 | $3,805.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,623.00 / $4,746.00 / $8,812.00
| Facility | | $1,623.00 | $4,746.00 | $8,812.00 |