- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $4,897.79 / $14,125.38
| Facility | | $616.60 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $8,317.64 / $10,964.78
| Facility | | $3,801.89 | $8,317.64 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $407.38 / $457.09
| Facility | | $371.54 | $407.38 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $1,122.02 / $1,318.26
| Facility | | $1,122.02 | $1,122.02 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,715.35 / $6,456.54
| Facility | | $1,348.96 | $3,715.35 | $6,456.54 |