- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,949.84 / $9,772.37
| Facility | | $645.65 | $1,949.84 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,073.80 / $9,549.93
| Facility | | $2,630.27 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $562.34 / $794.33
| Facility | | $457.09 | $562.34 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $2,290.87
| Facility | | $912.01 | $912.01 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,698.24 / $6,309.57
| Facility | | $575.44 | $1,698.24 | $6,309.57 |