- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $6,025.60 / $16,595.87
| Facility | | $524.81 | $6,025.60 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $5,128.61 / $9,549.93
| Facility | | $2,137.96 | $5,128.61 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $1,230.27
| Facility | | $1,230.27 | $1,230.27 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $269.15 / $446.68
| Facility | | $186.21 | $269.15 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $10,964.78 / $16,982.44
| Facility | | $2,754.23 | $10,964.78 | $16,982.44 |