- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $4,897.79 / $7,244.36
| Facility | | $371.54 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,317.64 / $11,220.18
| Facility | | $2,344.23 | $8,317.64 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $346.74 / $380.19
| Facility | | $323.59 | $346.74 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,318.26 / $1,318.26
| Facility | | $1,318.26 | $1,318.26 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,715.35 / $6,456.54
| Facility | | $1,548.82 | $3,715.35 | $6,456.54 |