- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $560.22 / $7,838.38 / $7,838.38
| Facility | | $560.22 | $7,838.38 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,508.42 / $6,181.55 / $10,081.29
| Facility | | $2,508.42 | $6,181.55 | $10,081.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.29 / $596.29 / $3,456.15
| Facility | | $596.29 | $596.29 | $3,456.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.65 / $661.27 / $835.67
| Facility | | $501.65 | $661.27 | $835.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,705.00 / $11,259.00 / $12,494.00
| Facility | | $1,705.00 | $11,259.00 | $12,494.00 |