- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,344.23 / $6,309.57
| Facility | | $724.44 | $2,344.23 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,548.82 / $2,691.53
| Facility | | $549.54 | $1,548.82 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $2,089.30 / $3,467.37
| Facility | | $446.68 | $2,089.30 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $478.63 / $3,630.78
| Facility | | $338.84 | $478.63 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,235.94 / $5,370.32
| Facility | | $1,949.84 | $3,235.94 | $5,370.32 |