- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $4,897.79 / $11,220.18
| Facility | | $537.03 | $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
- $323.59 / $354.81 / $398.11
| Facility | | $323.59 | $354.81 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $4,677.35 / $5,623.41
| Facility | | $4,677.35 | $4,677.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,025.60 / $12,022.64
| Facility | | $3,388.44 | $6,025.60 | $12,022.64 |