- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.76 / $4,247.17 / $7,278.60
| Facility | | $336.76 | $4,247.17 | $7,278.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,210.52 / $6,357.94 / $12,605.63
| Facility | | $3,210.52 | $6,357.94 | $12,605.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.51 / $1,495.43 / $3,597.47
| Facility | | $1,054.51 | $1,495.43 | $3,597.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $857.24 / $1,367.18 / $2,832.65
| Facility | | $857.24 | $1,367.18 | $2,832.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.32 / $1,202.76 / $4,717.47
| Facility | | $472.32 | $1,202.76 | $4,717.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |