- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,949.84 / $4,570.88
| Facility | | $602.56 | $1,949.84 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $6,606.93 / $10,715.19
| Facility | | $3,630.78 | $6,606.93 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $302.00 / $2,818.38
| Facility | | $39.81 | $302.00 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $812.83 / $4,265.80
| Facility | | $588.84 | $812.83 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,630.27 / $7,943.28
| Facility | | $831.76 | $2,630.27 | $7,943.28 |