- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,801.89 / $5,623.41
| Facility | | $724.44 | $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
- $630.96 / $645.65 / $741.31
| Facility | | $630.96 | $645.65 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $831.76 / $1,318.26
| Facility | | $660.69 | $831.76 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $11,220.18 / $17,378.01
| Facility | | $4,265.80 | $11,220.18 | $17,378.01 |