- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $4,897.79 / $14,125.38
| Facility | | $851.14 | $4,897.79 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $13,803.84 / $19,054.61
| Facility | | $4,365.16 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $776.25 / $851.14
| Facility | | $724.44 | $776.25 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,137.96 / $2,137.96
| Facility | | $2,137.96 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $7,762.47 / $10,964.78
| Facility | | $2,630.27 | $7,762.47 | $10,964.78 |