- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.86 / $7,506.56 / $13,273.48
| Facility | | $546.86 | $7,506.56 | $13,273.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,815.49 / $9,289.21 / $20,505.30
| Facility | | $2,815.49 | $9,289.21 | $20,505.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,278.05 / $1,994.71 / $4,798.54
| Facility | | $1,278.05 | $1,994.71 | $4,798.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,107.54 / $1,820.30 / $3,778.38
| Facility | | $1,107.54 | $1,820.30 | $3,778.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.09 / $2,705.10 / $7,773.00
| Facility | | $723.09 | $2,705.10 | $7,773.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,437.00 / $9,370.00 / $12,774.00
| Facility | | $3,437.00 | $9,370.00 | $12,774.00 |