- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.62 / $5,000.27 / $7,838.38
| Facility | | $771.62 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.61 / $8,392.32 / $13,362.65
| Facility | | $2,423.61 | $8,392.32 | $13,362.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.14 / $553.14 / $1,656.16
| Facility | | $553.14 | $553.14 | $1,656.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $378.50 / $535.35 / $751.76
| Facility | | $378.50 | $535.35 | $751.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.00 / $3,085.00 / $5,060.00
| Facility | | $755.00 | $3,085.00 | $5,060.00 |