- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,778.28 / $8,511.38
| Facility | | $724.44 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,801.89 / $8,511.38
| Facility | | $2,344.23 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,096.48 / $1,412.54
| Facility | | $831.76 | $1,096.48 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $1,862.09
| Facility | | $1,479.11 | $1,479.11 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |