- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,778.28 / $9,332.54
| Facility | | $616.60 | $1,778.28 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,801.89 / $8,511.38
| Facility | | $2,290.87 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $630.96 / $812.83
| Facility | | $457.09 | $630.96 | $812.83 |
- 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 |