- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,467.37 / $5,623.41
| Facility | | $562.34 | $3,467.37 | $5,623.41 |
- 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
- $457.09 / $501.19 / $562.34
| Facility | | $457.09 | $501.19 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $691.83 / $1,023.29
| Facility | | $489.78 | $691.83 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $6,025.60 / $10,715.19
| Facility | | $2,691.53 | $6,025.60 | $10,715.19 |