- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $3,890.45 / $9,120.11
| Facility | | $676.08 | $3,890.45 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $5,248.07 / $5,495.41
| Facility | | $1,548.82 | $5,248.07 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $645.65 / $4,168.69
| Facility | | $380.19 | $645.65 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,570.40 / $4,677.35
| Facility | | $1,548.82 | $2,570.40 | $4,677.35 |