- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $458.70 / $6,196.55 / $9,092.54
| Facility | | $458.70 | $6,196.55 | $9,092.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.47 / $1,657.11 / $2,812.07
| Facility | | $1,506.47 | $1,657.11 | $2,812.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.02 / $1,620.46 / $2,702.90
| Facility | | $346.02 | $1,620.46 | $2,702.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.27 / $416.18 / $584.00
| Facility | | $297.27 | $416.18 | $584.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.58 / $7,909.30 / $26,542.00
| Facility | | $1,703.58 | $7,909.30 | $26,542.00 |