- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,290.87 / $8,511.38
| Facility | | $776.25 | $2,290.87 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,715.19 / $11,220.18
| Facility | | $6,456.54 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,047.13 / $1,230.27
| Facility | | $776.25 | $1,047.13 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,348.96 / $1,412.54
| Facility | | $34.67 | $1,348.96 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,445.44 / $5,248.07
| Facility | | $524.81 | $1,445.44 | $5,248.07 |