- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $2,754.23 / $6,760.83
| Facility | | $467.74 | $2,754.23 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $4,365.16 / $6,456.54
| Facility | | $2,290.87 | $4,365.16 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $2,754.23 / $2,754.23
| Facility | | $263.03 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,148.15 / $2,041.74
| Facility | | $512.86 | $1,148.15 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,398.83 / $6,606.93
| Facility | | $831.76 | $2,398.83 | $6,606.93 |