- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $4,897.79 / $7,244.36
| Facility | | $954.99 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,454.40 / $19,498.45
| Facility | | $6,456.54 | $14,454.40 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $954.99 / $1,071.52
| Facility | | $851.14 | $954.99 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,288.25 / $1,949.84
| Facility | | $912.01 | $1,288.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,715.35 / $6,456.54
| Facility | | $2,398.83 | $3,715.35 | $6,456.54 |