- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $5,248.07 / $8,709.64
| Facility | | $512.86 | $5,248.07 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,890.45 / $4,073.80
| Facility | | $2,041.74 | $3,890.45 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,288.25 / $1,949.84
| Facility | | $1,288.25 | $1,288.25 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $457.09 / $5,623.41
| Facility | | $309.03 | $457.09 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,454.71 / $4,677.35
| Facility | | $1,445.44 | $2,454.71 | $4,677.35 |