- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $3,801.89 / $5,623.41
| Facility | | $338.84 | $3,801.89 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $18,197.01 / $26,302.68
| Facility | | $2,398.83 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $302.00 / $338.84
| Facility | | $288.40 | $302.00 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $478.63 / $630.96
| Facility | | $295.12 | $478.63 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,025.60 / $10,715.19
| Facility | | $3,388.44 | $6,025.60 | $10,715.19 |