- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $1,949.84 / $9,120.11
| Facility | | $407.38 | $1,949.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,073.80 / $9,549.93
| Facility | | $2,630.27 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $489.78 / $691.83
| Facility | | $354.81 | $489.78 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $2,290.87
| Facility | | $660.69 | $660.69 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,754.23 / $6,309.57
| Facility | | $602.56 | $2,754.23 | $6,309.57 |