- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.06 / $7,838.38 / $8,763.29
| Facility | | $488.06 | $7,838.38 | $8,763.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,703.05 / $8,740.11 / $13,916.43
| Facility | | $2,703.05 | $8,740.11 | $13,916.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $582.25 / $582.25 / $3,456.15
| Facility | | $582.25 | $582.25 | $3,456.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.48 / $457.96 / $653.58
| Facility | | $334.48 | $457.96 | $653.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $6,599.00 / $7,158.00
| Facility | | $936.00 | $6,599.00 | $7,158.00 |