- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $4,786.30 / $8,317.64
| Facility | | $416.87 | $4,786.30 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,570.88 / $8,317.64
| Facility | | $2,238.72 | $4,570.88 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $7,079.46 / $8,511.38
| Facility | | $3,548.13 | $7,079.46 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $467.74 / $5,888.44
| Facility | | $288.40 | $467.74 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,630.27 / $4,786.30
| Facility | | $1,819.70 | $2,630.27 | $4,786.30 |