- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,801.89 / $11,220.18
| Facility | | $660.69 | $3,801.89 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $11,481.54 / $19,054.61
| Facility | | $3,715.35 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $660.69 / $758.58
| Facility | | $602.56 | $660.69 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,174.90 / $1,737.80
| Facility | | $741.31 | $1,174.90 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $7,762.47 / $10,964.78
| Facility | | $2,691.53 | $7,762.47 | $10,964.78 |