- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $4,897.79 / $14,125.38
| Facility | | $954.99 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $28,183.83 / $39,810.72
| Facility | | $5,128.61 | $28,183.83 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $645.65 / $724.44
| Facility | | $588.84 | $645.65 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $4,677.35 / $5,623.41
| Facility | | $4,677.35 | $4,677.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,762.47 / $10,964.78
| Facility | | $4,073.80 | $7,762.47 | $10,964.78 |