- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $5,011.87 / $9,332.54
| Facility | | $446.68 | $5,011.87 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $11,481.54 / $26,915.35
| Facility | | $1,380.38 | $11,481.54 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,698.24 / $4,073.80
| Facility | | $1,071.52 | $1,698.24 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $977.24 / $977.24 / $977.24
| Facility | 22 | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,621.81 / $3,235.94
| Facility | | $1,318.26 | $1,621.81 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $912.01 / $4,786.30
| Facility | | $467.74 | $912.01 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $5,248.07 / $9,332.54
| Facility | | $1,445.44 | $5,248.07 | $9,332.54 |