- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,584.89 / $5,128.61
| Facility | | $741.31 | $1,584.89 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $14,791.08 / $42,657.95
| Facility | | $5,754.40 | $14,791.08 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,818.38 / $6,760.83
| Facility | | $1,778.28 | $2,818.38 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,691.53 / $5,248.07
| Facility | | $2,187.76 | $2,691.53 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,318.26 / $4,786.30
| Facility | | $741.31 | $1,318.26 | $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 |