- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $933.25 / $10,715.19
| Facility | | $933.25 | $933.25 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $34,673.69 / $81,283.05
| Facility | | $5,370.32 | $34,673.69 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $3,162.28 / $7,413.10
| Facility | | $2,238.72 | $3,162.28 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,019.95 / $5,888.44
| Facility | | $2,398.83 | $3,019.95 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,570.40 / $46,773.51
| Facility | | $1,318.26 | $2,570.40 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $10,964.78 / $47,863.01
| Facility | | $1,584.89 | $10,964.78 | $47,863.01 |