- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,090.30 / $9,120.11
| Facility | | $812.83 | $3,090.30 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $4,570.88 / $50,118.72
| Facility | | $34.67 | $4,570.88 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $3,467.37 / $9,772.37
| Facility | | $2,818.38 | $3,467.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $50,118.72 / $75,857.76
| Facility | | $4,265.80 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,168.69 / $9,120.11
| Facility | | $1,659.59 | $4,168.69 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $2,137.96 / $2,884.03
| Facility | | $1,949.84 | $2,137.96 | $2,884.03 |