- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,630.27 / $8,511.38
| Facility | | $467.74 | $2,630.27 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $11,220.18 / $11,748.98
| Facility | | $9,549.93 | $11,220.18 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $436.52 / $524.81
| Facility | | $309.03 | $436.52 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $588.84 / $588.84
| Facility | | $34.67 | $588.84 | $588.84 |
- 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 |