- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $3,890.45 / $9,120.11
| Facility | | $380.19 | $3,890.45 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $1,862.09 / $1,862.09
| Facility | | $1,778.28 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $436.52 / $9,549.93
| Facility | | $229.09 | $436.52 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,884.03 / $6,309.57
| Facility | | $1,862.09 | $2,884.03 | $6,309.57 |