- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $3,801.89 / $8,912.51
| Facility | | $549.54 | $3,801.89 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $13,803.84 / $19,054.61
| Facility | | $2,187.76 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $380.19 / $426.58
| Facility | | $338.84 | $380.19 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $588.84 / $1,288.25
| Facility | | $416.87 | $588.84 | $1,288.25 |
- 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 |