- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,778.28 / $8,511.38
| Facility | | $616.60 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,801.89 / $8,511.38
| Facility | | $2,290.87 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $794.33 / $1,096.48
| Facility | | $562.34 | $794.33 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,071.52 / $1,862.09
| Facility | | $691.83 | $1,071.52 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,445.44 / $5,248.07
| Facility | | $524.81 | $1,445.44 | $5,248.07 |