- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $4,786.30 / $10,471.29
| Facility | | $776.25 | $4,786.30 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,570.40 / $2,884.03
| Facility | | $1,548.82 | $2,570.40 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $776.25 / $4,466.84
| Facility | | $467.74 | $776.25 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,630.78 / $5,623.41
| Facility | | $1,548.82 | $3,630.78 | $5,623.41 |