- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $7,244.36 / $20,892.96
| Facility | | $776.25 | $7,244.36 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,623.41 / $10,471.29
| Facility | | $2,344.23 | $5,623.41 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $2,089.30 / $2,691.53
| Facility | | $501.19 | $2,089.30 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.84 / $416.87 / $645.65
| Facility | | $281.84 | $416.87 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $11,220.18 / $16,982.44
| Facility | | $2,754.23 | $11,220.18 | $16,982.44 |