- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $1,949.84 / $9,120.11
| Facility | | $309.03 | $1,949.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,073.80 / $9,549.93
| Facility | | $2,570.40 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $371.54 / $478.63
| Facility | | $275.42 | $371.54 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $501.19 / $2,290.87
| Facility | | $489.78 | $501.19 | $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 |