- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $7,943.28 / $16,595.87
| Facility | | $758.58 | $7,943.28 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,128.61 / $9,772.37
| Facility | | $2,137.96 | $5,128.61 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $1,949.84
| Facility | | $1,513.56 | $1,513.56 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $891.25 / $1,513.56
| Facility | | $645.65 | $891.25 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $16,982.44
| Facility | | $2,754.23 | $11,220.18 | $16,982.44 |