- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $2,951.21 / $6,309.57
| Facility | | $707.95 | $2,951.21 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $5,248.07 / $7,244.36
| Facility | | $5,248.07 | $5,248.07 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $724.44 / $1,071.52
| Facility | | $562.34 | $724.44 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $691.83 / $4,677.35
| Facility | | $512.86 | $691.83 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,570.88 / $10,715.19
| Facility | | $1,995.26 | $4,570.88 | $10,715.19 |