- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,467.37 / $11,481.54
| Facility | | $870.96 | $3,467.37 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $3,981.07 / $7,762.47
| Facility | | $2,187.76 | $3,981.07 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $2,951.21 / $2,951.21
| Facility | | $275.42 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,398.83 / $2,398.83
| Facility | | $2,398.83 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $45,708.82 / $45,708.82
| Facility | | $9,549.93 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $602.56 / $5,128.61
| Facility | | $302.00 | $602.56 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $389.05 / $660.69
| Facility | | $281.84 | $389.05 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,709.64
| Facility | | $1,380.38 | $4,073.80 | $8,709.64 |