- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,778.28 / $8,511.38
| Facility | | $575.44 | $1,778.28 | $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
- $338.84 / $478.63 / $562.34
| Facility | | $338.84 | $478.63 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $645.65 / $645.65
| Facility | | $34.67 | $645.65 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $28,183.83 / $81,283.05
| Facility | | $3,019.95 | $28,183.83 | $81,283.05 |