- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $3,630.78 / $8,511.38
| Facility | | $891.25 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,715.35 / $3,981.07
| Facility | | $2,041.74 | $3,715.35 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $2,630.27 / $8,709.64
| Facility | | $2,398.83 | $2,630.27 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $645.65 / $3,548.13
| Facility | | $389.05 | $645.65 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,884.03 / $4,677.35
| Facility | | $1,445.44 | $2,884.03 | $4,677.35 |