- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,454.71 / $6,456.54
| Facility | | $912.01 | $2,454.71 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $3,981.07 / $5,888.44
| Facility | | $1,659.59 | $3,981.07 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $954.99 / $3,090.30
| Facility | | $501.19 | $954.99 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $7,943.28 / $33,884.42
| Facility | | $7,943.28 | $7,943.28 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $4,466.84 / $7,585.78
| Facility | | $1,737.80 | $4,466.84 | $7,585.78 |