- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,818.38 / $9,332.54
| Facility | | $794.33 | $2,818.38 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $5,888.44 / $13,182.57
| Facility | | $3,715.35 | $5,888.44 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $691.83 / $954.99
| Facility | | $562.34 | $691.83 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,096.48 / $1,096.48
| Facility | | $34.67 | $1,096.48 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | 22 | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $8,511.38
| Facility | | $630.96 | $1,862.09 | $8,511.38 |