- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $1,778.28 / $8,511.38
| Facility | | $446.68 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $3,801.89 / $8,511.38
| Facility | | $2,344.23 | $3,801.89 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $416.87 / $489.78
| Facility | | $295.12 | $416.87 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $562.34 / $1,862.09
| Facility | | $489.78 | $562.34 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $14,125.38 / $33,113.11
| Facility | | $1,174.90 | $14,125.38 | $33,113.11 |