- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $4,897.79 / $11,220.18
| Facility | | $794.33 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $13,803.84 / $19,054.61
| Facility | | $3,715.35 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $537.03 / $602.56
| Facility | | $512.86 | $537.03 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $724.44 / $1,096.48
| Facility | | $524.81 | $724.44 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $7,762.47 / $10,964.78
| Facility | | $2,884.03 | $7,762.47 | $10,964.78 |