- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,235.94 / $7,413.10
| Facility | | $1,513.56 | $3,235.94 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,548.82 / $3,235.94
| Facility | | $758.58 | $1,548.82 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,772.37 / $11,220.18
| Facility | | $6,309.57 | $9,772.37 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $457.09 / $7,079.46
| Facility | | $54.95 | $457.09 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,019.95 / $5,754.40
| Facility | | $2,137.96 | $3,019.95 | $5,754.40 |