- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $4,365.16 / $8,511.38
| Facility | | $912.01 | $4,365.16 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $4,265.80 / $6,760.83
| Facility | | $3,162.28 | $4,265.80 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $933.25 / $6,025.60
| Facility | | $537.03 | $933.25 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,570.40 / $4,677.35
| Facility | | $1,548.82 | $2,570.40 | $4,677.35 |