- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,949.84 / $9,772.37
| Facility | | $758.58 | $1,949.84 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,073.80 / $9,549.93
| Facility | | $2,570.40 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $588.84 / $831.76
| Facility | | $478.63 | $588.84 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $954.99 / $2,290.87
| Facility | | $954.99 | $954.99 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $8,511.38
| Facility | | $630.96 | $1,862.09 | $8,511.38 |