- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $6,025.60 / $9,772.37
| Facility | | $912.01 | $6,025.60 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $7,413.10 / $13,803.84
| Facility | | $3,162.28 | $7,413.10 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $1,949.84
| Facility | | $371.54 | $371.54 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $794.33 / $1,445.44
| Facility | | $549.54 | $794.33 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $13,182.57 / $23,988.33
| Facility | | $5,128.61 | $13,182.57 | $23,988.33 |