- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $3,235.94 / $12,302.69
| Facility | | $812.83 | $3,235.94 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $5,128.61 / $13,803.84
| Facility | | $3,090.30 | $5,128.61 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,019.95 / $7,079.46
| Facility | | $2,137.96 | $3,019.95 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,884.03 / $5,623.41
| Facility | | $2,290.87 | $2,884.03 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,659.59 / $5,011.87
| Facility | | $851.14 | $1,659.59 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $4,786.30 / $8,912.51
| Facility | | $2,398.83 | $4,786.30 | $8,912.51 |