- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $4,897.79 / $11,220.18
| Facility | | $794.33 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $13,803.84 / $19,054.61
| Facility | | $3,715.35 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $478.63 / $549.54
| Facility | | $446.68 | $478.63 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $776.25 / $1,096.48
| Facility | | $446.68 | $776.25 | $1,096.48 |
- 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 |