- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $8,912.51 / $16,595.87
| Facility | | $933.25 | $8,912.51 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $10,471.29 / $19,952.62
| Facility | | $5,754.40 | $10,471.29 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $3,630.78 / $4,677.35
| Facility | | $3,630.78 | $3,630.78 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $2,454.71 / $7,079.46
| Facility | | $380.19 | $2,454.71 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,417.38 / $25,703.96
| Facility | | $8,709.64 | $20,417.38 | $25,703.96 |