- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $4,897.79 / $11,220.18
| Facility | | $954.99 | $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
- $537.03 / $588.84 / $676.08
| Facility | | $537.03 | $588.84 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $954.99 / $1,412.54
| Facility | | $575.44 | $954.99 | $1,412.54 |
- 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 |