- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $2,951.21 / $7,244.36
| Facility | | $691.83 | $2,951.21 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,317.64 / $10,471.29
| Facility | | $2,344.23 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $489.78 / $549.54
| Facility | | $467.74 | $489.78 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $776.25 / $1,230.27
| Facility | | $501.19 | $776.25 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $6,025.60 / $10,715.19
| Facility | | $2,691.53 | $6,025.60 | $10,715.19 |