- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $1,778.28 / $8,317.64
| Facility | | $537.03 | $1,778.28 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $6,760.83 / $13,182.57
| Facility | | $2,630.27 | $6,760.83 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $645.65 / $831.76
| Facility | | $467.74 | $645.65 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $1,862.09
| Facility | | $870.96 | $870.96 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,890.45 / $8,511.38
| Facility | | $741.31 | $3,890.45 | $8,511.38 |