- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $1,778.28 / $8,511.38
| Facility | | $416.87 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,884.03 / $5,888.44
| Facility | | $1,584.89 | $2,884.03 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $281.84 / $398.11
| Facility | | $229.09 | $281.84 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $457.09 / $457.09
| Facility | | $34.67 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $549.54 / $549.54 / $549.54
| Facility | 22 | $549.54 | $549.54 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,348.96 / $5,248.07
| Facility | | $524.81 | $1,348.96 | $5,248.07 |