- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,467.37 / $7,244.36
| Facility | | $912.01 | $3,467.37 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $13,803.84 / $19,054.61
| Facility | | $2,344.23 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $831.76 / $954.99
| Facility | | $812.83 | $831.76 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,445.44 / $2,238.72
| Facility | | $758.58 | $1,445.44 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,762.47 / $10,964.78
| Facility | | $2,951.21 | $7,762.47 | $10,964.78 |