- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,344.23 / $4,897.79
| Facility | | $478.63 | $2,344.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $14,454.40 / $19,498.45
| Facility | | $6,456.54 | $14,454.40 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $436.52 / $501.19
| Facility | | $426.58 | $436.52 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $676.08 / $758.58
| Facility | | $426.58 | $676.08 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $5,754.40 / $12,022.64
| Facility | | $1,412.54 | $5,754.40 | $12,022.64 |