- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $4,365.16 / $9,120.11
| Facility | | $831.76 | $4,365.16 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $25,703.96 / $32,359.37
| Facility | | $9,549.93 | $25,703.96 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $741.31 / $831.76
| Facility | | $707.95 | $741.31 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,412.54 / $6,760.83
| Facility | | $812.83 | $1,412.54 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $10,964.78 / $17,378.01
| Facility | | $4,365.16 | $10,964.78 | $17,378.01 |