- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,511.89 / $8,511.38
| Facility | | $537.03 | $2,511.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,981.07 / $7,762.47
| Facility | | $2,137.96 | $3,981.07 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $3,715.35 / $3,715.35
| Facility | | $295.12 | $3,715.35 | $3,715.35 |
- 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 / $19,498.45 / $19,498.45
| Facility | | $9,549.93 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $588.84 / $4,365.16
| Facility | | $316.23 | $588.84 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $398.11 / $707.95
| Facility | | $302.00 | $398.11 | $707.95 |
- 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 |