- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,630.78 / $12,022.64
| Facility | | $977.24 | $3,630.78 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,011.87 / $9,772.37
| Facility | | $2,884.03 | $5,011.87 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $2,570.40 / $2,570.40
| Facility | | $758.58 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $1,949.84
| Facility | | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $45,708.82 / $45,708.82
| Facility | | $8,912.51 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,122.02 / $4,786.30
| Facility | | $794.33 | $1,122.02 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $977.24 / $1,548.82
| Facility | | $776.25 | $977.24 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,128.61 / $10,964.78
| Facility | | $1,698.24 | $5,128.61 | $10,964.78 |