- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $4,897.79 / $16,595.87
| Facility | | $537.03 | $4,897.79 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $4,466.84 / $9,120.11
| Facility | | $2,290.87 | $4,466.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,778.28 / $2,290.87
| Facility | | $371.54 | $1,778.28 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $537.03 / $954.99
| Facility | | $354.81 | $537.03 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $16,982.44
| Facility | | $2,754.23 | $11,220.18 | $16,982.44 |