- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $2,818.38 / $10,471.29
| Facility | | $870.96 | $2,818.38 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $10,715.19 / $11,220.18
| Facility | | $8,912.51 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,258.93 / $1,479.11
| Facility | | $891.25 | $1,258.93 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,698.24 / $1,698.24
| Facility | | $34.67 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,890.45 / $8,511.38
| Facility | | $741.31 | $3,890.45 | $8,511.38 |