- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,630.27 / $8,511.38
| Facility | | $794.33 | $2,630.27 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $9,549.93 / $11,220.18
| Facility | | $5,128.61 | $9,549.93 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,621.81 / $2,238.72
| Facility | | $1,318.26 | $1,621.81 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,570.40 / $2,570.40
| Facility | | $34.67 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $4,168.69 / $30,199.52
| Facility | | $407.38 | $4,168.69 | $30,199.52 |