- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.07 / $3,224.71 / $7,161.40
| Facility | | $559.07 | $3,224.71 | $7,161.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,558.71 / $8,210.17 / $17,676.25
| Facility | | $2,558.71 | $8,210.17 | $17,676.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,484.07 / $2,104.59 / $5,062.89
| Facility | | $1,484.07 | $2,104.59 | $5,062.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,206.44 / $1,924.10 / $3,986.53
| Facility | | $1,206.44 | $1,924.10 | $3,986.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.69 / $1,359.60 / $8,568.71
| Facility | | $515.69 | $1,359.60 | $8,568.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |