- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $4,897.79 / $11,220.18
| Facility | | $691.83 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,317.64 / $10,471.29
| Facility | | $3,715.35 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $457.09 / $524.81
| Facility | | $416.87 | $457.09 | $524.81 |
- 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 |