- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $4,897.79 / $7,244.36
| Facility | | $549.54 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $13,803.84 / $19,054.61
| Facility | | $2,344.23 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $363.08 / $407.38
| Facility | | $331.13 | $363.08 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,137.96 / $2,511.89
| Facility | | $2,137.96 | $2,137.96 | $2,511.89 |
- 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 |