- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,818.38 / $10,471.29
| Facility | | $851.14 | $2,818.38 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $10,715.19 / $12,882.50
| Facility | | $8,128.31 | $10,715.19 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,148.15 / $1,348.96
| Facility | | $812.83 | $1,148.15 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,288.25 / $1,548.82
| Facility | | $34.67 | $1,288.25 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |