- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $831.76 / $7,762.47
| Facility | | $794.33 | $831.76 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $8,709.64 / $13,489.63
| Facility | | $3,311.31 | $8,709.64 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $912.01 / $1,659.59
| Facility | | $912.01 | $912.01 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $660.69 / $1,174.90
| Facility | | $501.19 | $660.69 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $6,025.60 / $12,022.64
| Facility | | $645.65 | $6,025.60 | $12,022.64 |