- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $7,079.46 / $21,877.62
| Facility | | $794.33 | $7,079.46 | $21,877.62 |
- 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
- $630.96 / $707.95 / $891.25
| Facility | | $630.96 | $707.95 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,258.93 / $1,862.09
| Facility | | $758.58 | $1,258.93 | $1,862.09 |
- 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 |