- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $4,897.79 / $14,125.38
| Facility | | $870.96 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $13,803.84 / $19,054.61
| Facility | | $4,365.16 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $575.44 / $660.69
| Facility | | $524.81 | $575.44 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $954.99 / $1,513.56
| Facility | | $645.65 | $954.99 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $7,762.47 / $10,964.78
| Facility | | $2,691.53 | $7,762.47 | $10,964.78 |