- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,162.28 / $8,511.38
| Facility | | $831.76 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $9,772.37 / $19,498.45
| Facility | | $4,897.79 | $9,772.37 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $724.44 / $758.58
| Facility | | $79.43 | $724.44 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $64,565.42
| Facility | | $54.95 | $56.23 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,096.48 / $4,570.88
| Facility | | $707.95 | $1,096.48 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $933.25 / $1,778.28
| Facility | | $707.95 | $933.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,317.64 / $17,782.79
| Facility | | $2,630.27 | $8,317.64 | $17,782.79 |