- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $933.25 / $7,762.47
| Facility | | $891.25 | $933.25 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $9,772.37 / $15,488.17
| Facility | | $3,311.31 | $9,772.37 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,995.26
| Facility | | $1,023.29 | $1,023.29 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $724.44 / $1,230.27
| Facility | | $562.34 | $724.44 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $7,762.47 / $15,488.17
| Facility | | $794.33 | $7,762.47 | $15,488.17 |